Long-Term Care

This survey reports on trends in Medicaid spending, enrollment and policy initiatives for FY 2012 and FY 2013. The report describes policy changes in reimbursement, eligibility, benefits, delivery systems and long-term care, as well as detailed appendices with state-by-state information, and a more in-depth look through four state-specific case studies of the Medicaid budget and policy decisions in Massachusetts, Ohio, Oregon and Texas.

Washington is the first state to enter into a MOU to participate in the new managed-fee-for-service Demonstration to integrate the service delivery across primary, acute, prescription drugs, behavioral health and LTSS. This document details the principles under which CMS and the State plan to implement and operate the Demonstration. It also outlines the activities CMS and the State plan to conduct in preparation for implementation of the Demonstration and initiate the Demonstration.

Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid. This policy brief summarizes the MOU terms in the several key areas, including enrollment, care delivery model, benefits, financing, beneficiary protections and monitoring and evaluation.

This document provides an overview of the joint efforts of states and the CMS to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. As an outgrowth of the Affordable Care Act, CMS is reviewing proposals from states to test two new models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries with the goal of delivering better coordinated care and reducing costs.

The number of workers with eldercare responsibilities is on the rise. This trend highlights the need to better understand the impact of family caregiving on work, and how working caregivers can better manage their work and caregiving responsibilities. The fact sheet highlights research about how caregivers juggle commitments and how responsibilities can interfere with employment.

The affordability of private pay services is an important component of LTSS system performance. This Insight on the Issues presents data on private pay affordability for every state and more than 400 markets in the U.S. There is wide variation in affordability between states and markets. Private pay nursing home care is not affordable for middle-income families. While less costly than nursing homes, home health care is still unaffordable for middle-income older people at typical levels of use.

This report seeks to understand quality care from a unique perspective; the individual receiving or accessing paid care services and support in their own home. The Consumer Voice convened interviews, surveys, and a national focus group to determine how consumers define quality care, pinpoint needed care improvements and recommend policy actions to provide more access to quality home care. This report provides consumers with an opportunity to speak out and contribute to shaping the policies.

This study challenges the common perception of family caregiving as a set of personal care and household chores that most adults already do or can easily master. The major shift is that the role of family caregivers has dramatically expanded to include performing medical/nursing tasks of the kind and complexity once only provided in hospitals. The findings highlight an urgent need for both individual and collective action. The report makes ten recommendations to support the current caregivers.

The Senate Finance Committee asked GAO to analyze states' requirements and practices for assessing the financial eligibility of applicants for Medicaid long-term care coverage. This report presents findings on the extent to which states (1) require documentation on assets from applicants, (2) obtain information from third parties to verify applicants' assets, and (3) obtain information about applicants' assets that could be used to implement eligibility-related DRA provisions.

Coordination of care activities and concepts include common cross-cutting themes. This report puts forth information regarding components of interventions that should be considered in the design, ongoing operation, and evaluation phases of most coordination of care efforts. It includes definitions, descriptions of funding programs, clinical programs, frameworks, and other state- and federal-level initiatives. The report pays particular attention to efforts germane to behavioral health disorders.