Expenditures

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An Investigation of Interstate Variation in Medicaid Long-Term Care Use and Expenditures Across 40 States in 2006

Shifting the balance in publicly-funded long-term care provision away from institutional care toward greater reliance on home and community-based services has been a federal goal for the past three decades -- a goal often referred to as "re-balancing" state LTC systems. This report explores inter-state variations in LTC expenditure and service use patterns, in terms of institutional and non-institutional services, and also by Medicaid LTC users' age and type of disability.

Short URL: http://www.advancingstates.org/node/65900

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Disabled Dual-Eligible Beneficiaries: Integration of Medicare and Medicaid Benefits May Not Lead to Expected Medicare Savings

In this report, the GAO examined claims, expenditure, and quality data from Dual Eligible Special Needs Plans (D-SNPs) during 2009. The GAO notes that D-SNPs with higher levels of Medicare and Medicaid integration performed better on quality outcomes but did not reduce utilization of costly Medicare services. The GAO concludes that CMS projected savings from the Financial Alignment Demonstration and other initiatives to integrate care for dual eligible beneficiaries may be overstated.

Short URL: http://www.advancingstates.org/node/65894

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Evaluating PACE: A Review of the Literature

This report brings together available evidence on the effect of PACE on several key outcomes: Medicare and Medicaid costs, hospital and nursing home utilization, quality of care, satisfaction and quality of life, and mortality. The authors summarize findings from past studies and assess their methodological approach. They improve on these earlier evaluations by conducting a more detailed review of the studies, as well as a more rigorous assessment of the quality of evidence presented in each.

Short URL: http://www.advancingstates.org/node/65892

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The Changing Medical and Long-Term Care Expenditures of People Who Transition from Institutional Care to Home- and Community-Based Services

The Money Follows the Person (MFP) demonstration grant program helps long-term residents of institutions move back to the community. This report aims to answer several questions about the expenditures (medical care and long-term services and supports [LTSS] expenditures) of people who transition from institutional care to community-based LTSS.

Short URL: http://www.advancingstates.org/node/65855

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Medicaid Expenditures for Long-Term Services and Supports in FFY 2012

The annual Medicaid Long Term Services and Supports expenditure report for FFY 2012 is now available. The report includes Medicaid expenditures for all LTSS, including institutional and non-institutional settings, by service category and state. The data comes primarily from CMS-64 reports.

Short URL: http://www.advancingstates.org/node/65301

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President’s Budget Proposal Fiscal Year 2013

President Obama’s proposed budget outlines the Administration’s fiscal and program priorities for FY13. ADvancing States’s preliminary analysis is framed by an interest in aging and disability program funding. The analysis reveals the proposal’s requests for food and nutrition services, independent living, caregiver support, protection of vulnerable adults, and Medicare and Medicaid. The accompanying chart shows the President’s FY12 and FY13 requests for relevant aging and disability programs.

Short URL: http://www.advancingstates.org/node/53163

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The Budget Lifecycle

Determining the federal budget for the coming fiscal year (FY) is nearly a year-long process. This flow chart explains the federal budget’s lifecycle—from federal agencies’ justification for funds to the House and Senate Appropriations Committees to the President’s authorization. It is a concise visualization of the process leading up to a federal fiscal year commencement.

Short URL: http://www.advancingstates.org/node/53171

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Summary of Senate Finance Committee Report on Health Care Financing Options

This report summarizes the May 2009 Senate Finance Committee’s proposed option for reforming health care financing. The three areas of proposed funding reforms are reductions in current health care spending; reevaluation of health tax subsidies; and changes in non-health tax provisions, such as imposing alcohol and sugar-sweetened beverage excise taxes. The proposed option reveals what areas the Finance Committee prioritizes during health care finance reform and where cuts are recommended.

Short URL: http://www.advancingstates.org/node/53180

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Strengthening the Aging Network Issue Brief: Medicaid Health Information Technology

There are many opportunities for states’ Medicaid information systems and administrative functions to be federally subsidized with funding. This brief describes the variety of administrative systems that qualify for federal financial participation (FFP), including the Medicaid Management Information System (MMIS) and health information technology (HIT). The systems are used to support people with disabilities and older adults.

Short URL: http://www.advancingstates.org/node/53169

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Preliminary Analysis of the Continuing Resolution for FY11

The federal government reached a compromise to the budget crisis for fiscal year 2011 (FY11) with a bill consisting of billions in cuts to discretionary spending. This analysis of the Continuing Resolution (CR) for FY11 discusses the inconsistent allocation of funding and provides descriptions of the appropriated amounts for different departments and programs, especially those impacting the aging and disability network. The report is complemented by a budget table showing the amount of funds.

Short URL: http://www.advancingstates.org/node/53162

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