Long-Term Care

This fact sheet describes “Community First Choice Option” – one of the rules that the CMS recently released to expand access to home and community based services (HCBS) for people with disabilities. States that elect the Community First Choice option are eligible for a 6 percentage point increase in their federal medical assistance percentage. Individuals who require an institutional level of care are eligible for the services, which will be offered in community-based settings.

The Affordable Care Act (ACA) established a voluntary public insurance program for long-term care: the Community Living Assistance Services and Supports (CLASS) Act. In October 2011, the Obama Administration suspended the CLASS Act because of the high risk of fiscal insolvency. This article discusses several CLASS Act design and implementation issues, including the voluntary enrollment, the weak work requirement, the lifetime and cash benefits, and the premium subsidy for low-income workers.

This critical essay examines how effectively the Patient Protection and Affordable Care Act (ACA) addresses prevailing deficiencies in the nation's long-term care system and whether the ACA will result in meaningful reform. This article also reviews the basic problems plaguing the long-term care sector and the provisions within the ACA meant to address them, including incentives/options for expanding home- and community-based care and a number of research and demonstration projects.

The coordination of Medicare and Medicaid benefits and services for dually eligible enrollees has been a longstanding policy challenge. Several provisions of the Affordable Care Act (ACA) attempt to address this lack of coordination. This paper reviews the major changes under the ACA directed at care coordination for the dually eligible population and then concludes with a discussion of the continuing legislative and legal challenges in integrating care for the dually eligible.

A statistical model was developed to assess the effect of rebalancing on overall spending for long-term services and supports (LTSS). The model indicates that spending is affected by the way rebalancing is implemented: Gradual rebalancing can reduce spending by about 15 percent over ten years. Because many states continue to experience budget crises, policy makers must think carefully before altering spending patterns for LTSS and adopt strategies to successfully reduce overall spending.

This study addresses issues related to the provisions of home and community-based services (HCBS) under the Affordable care Act (ACA) legislation of 2010. ACA allowed important voluntary provisions for the expansion of HCBS under Medicaid. Although the new provisions are valuable, the law does not set minimum standards for access to HCBS, and the new financial incentives are limited especially for the many states facing serious budget problems.

States provide long-term care services in homes and community-based settings through 1915(c) home and community-based services (HCBS) waiver programs. To ensure strong oversight of waiver programs, this report reviews documents from CMS's most recent quality review of waiver programs from 25 States, as well as information gathered from structured interviews with staff from the 10 CMS regional offices. The report also identify five recommendations to meet assurances related to quality of care.

This policy brief describes the long-term care insurance (LTCI) industry; in particular, it provides overview information about who buys the product, how much it costs, what the market looks like, and how the government has promoted the purchase of the private LTCI. In addition, this brief covers a variety of topics, including barriers to expansion of private LTCI, the LTC partnership program, and international lessons from another highly-developed country (France).

Centers for Medicare and Medicaid Services (CMS) has provided funding and technical assistance to states to develop state plans' to coordinate care for dual eligibles, persons eligible for both Medicare and Medicaid. This chart shows the status of those states selected for the Dual Demonstration grants, the model chosen, and target implementation. It also includes links to each state's plan.

PayingForSeniorCare.com website and the Eldercare Financial Resource Locator Tool were created and maintained by the American Elder Care Research Organization. The mission is to assist individuals in the planning and implementing of long-term senior care. The website is designed to help families and caregivers locate information about long-term care resources for their loved ones, and to find the public and private programs available to assist in covering the cost of such care.