Long-Term Care

ATI Advisory released extensive data analysis of Medicare claims data to highlight the disparate impact of the COVID-19 pandemic on individuals eligible for both Medicare and Medicaid (dual eligibles).The analysis also offers policy pathways for states to improve integrated care for this vulnerable population.

The GAO released a report on the impacts of the 2013 regulation that revised the domestic service employment and companionship services under the Fair Labor Standards Act (FLSA). This rule, which became effective in 2015, had the effect of extending minimum wage and overtime protections to a broader range of home care workers, many of whom provide Medicaid-funded home and community based services (HCBS).

CHCS and Speire Healthcare Strategies released a report about COVID-19 response efforts from states and health plans that offer integrated care programs for duals. People who are dually eligible for Medicare and Medicaid are among the nation’s most vulnerable to the coronavirus. The report outlines opportunities to support integration and identifies opportunities to strengthen programs and policies to best support the dual eligible population during the pandemic and in the future.

This issue brief from the MLTSS Institute focuses on aspects of delivering effective care to individuals eligible for both Medicare and Medicaid (dually eligible individuals).The brief provides a primer on the ways that Medicare data can help states better deliver care to dually eligible individuals; it also details information about data sources and other resources available to help obtain and analyze Medicare data.

NGA recently published a policy memo including a detailed table that provides an overview of state actions to address COVID-19 in long-term care facilities. The table includes notable actions from states with helpful links to relevant guidance and resources for each state. Updates on additional state actions and examples will be added to the table regularly and states are encouraged to contact NGA with changes.

Altarum recently published a special report highlighting the impact COVID-19 restrictions has had on nursing home residents. The report is the result of a survey that directly polled residents about their pandemic experience in 365 nursing homes in 36 states.

AARP has released its fourth iteration of the Long-term Services and Supports Scorecard. This scorecard ranks states and DC in order from 1 to 51 on a wide range of issues pertaining to older adults and people with disabilities. The LTSS scorecard has five domains that states are ranked within, and each of those domains has multiple indicators that are used to derive the overall score.

This brief draws from interviews with states operating new and long-standing MLTSS programs to identify six major trends in the refinement of MLTSS and underlying LTSS delivery systems nationally. The states examined in this brief are strengthening their Medicaid MLTSS programs to serve more LTSS beneficiaries and facilitate the development of integrated care programs that reduce service fragmentation for Medicare-Medicaid enrollees, particularly through Medicare Advantage D-SNPs

During the Friday September 25, 2020 MACPAC meeting, MACPAC presented on the Management of HCBS Waiver Waiting Lists. The talk included background information on Medicaid and HCBS Waivers, data on HCBS Waiver waiting lists, and strategies for reducing or eliminating waiting lists. The slides from this presentation are included here.

CMS has released a new report on community transitions that occurred under the Money Follows the Person (MFP) program from 2008 to the end of 2019. The report states that during this time, states transitioned 101,540 people to community living through MFP. In the most recent year (2019), MFP grantee states transitioned a total of 4,173 individuals. The report includes additional information on transitions broken down by population and state.