Long-Term Care

Explore Medicaid expansion under health care reform and savings for states through Medicaid “modernization.” This report examines three broad categories of savings opportunities including the greater use of coordinated care techniques, the greater use of managed care for LTC, and the upgrading of Medicaid’s administrative processes. Find national and state-specific projections of increases in Medicaid enrollees as a result of health reform legislation and of the associated Medicaid costs.

Explore this collaborative initiative geared towards propelling state progress in the support of a more “successful and financially secure aging experience.” The West Virginia Long Term Care Partnership seeks to bring together varied efforts to create an integrated network of thought and action, with an emphasis on collaboration and communication. Also included is a link to the proceedings of their 2010 Partner Summit, through which you can access the presentations and handouts.

Review an early assessment of the balance of state LTC systems before the implementation of the MFP demonstration. The authors’ goal was to develop a baseline against which the impacts could be measured as the program matures and evolves. This baseline information is used to identify key differences in the makeup of states’ LTC systems, and the observations suggest that the impacts of the program are likely to differ across states.

Learn about the status of the public LTC delivery system, and opportunities and obstacles for LTSS reform and rebalancing. The study surveys states’ current HCBS expenditures and utilization, analyzes factors underpinning Medicaid’s institutional bias, looks at federal and state initiatives to improve the ratio between institutional and community-based care, and points to statutory and regulatory “fixes” that could enhance the states’ ability to improve their LTC delivery systems.

Find a state-by-state summary of information on regulations that govern assisted living. Contact information for each state’s regulatory agency is listed as well as requirements for the physical plant, resident assessment, medication management, staffing, training, Medicaid reimbursement and more.

To inform long-term care reform efforts, a web-based survey of over 1,000 LTC specialists nationwide was conducted. Findings included the need for LTC to be rebalanced toward HCBS settings, though few supported doing so by limiting nursing home bed supply. Although virtually all felt that the federal government was doing a poor job regulating LTC providers, most believed that the approaches used to oversee nursing homes should also be applied to assisted living.

Fourth and final in a series that explores the cross-payer effects of providing Medicaid long-term supports and services on Medicare acute care resource use, this report provides a summary of the initial work of a study, described more fully in the first three reports, with an emphasis on lessons that state Medicaid administrators should consider as they move toward more formal programs of integrated care for persons dually eligible for Medicare and Medicaid.

As states assess the challenges and opportunities presented by federal health reform legislation, there is a natural tendency to focus on the most immediate issues, but it is equally important that states begin planning for the many aspects of implementation that occur in later years. This State Health Policy Briefing identifies and describes ten aspects of federal health reform that states must get right if they are to be successful in implementation.

What are the major components of the Community Living Assistance Services and Supports (CLASS) program? The program establishes a national, voluntary insurance program for purchasing community living services and supports that is designed to expand options for people who become functionally disabled and require long-term help. Find a description of the program, including its financing, eligibility criteria, benefit design and interaction with Medicaid.

What are the CLASS provisions for benefit determination, eligibility, enrollment, oversight, and administration of the program? This report discusses these issues as well as cost and financing for LTC services and the current market for private LTC insurance. Federal budget implications of the CLASS program, as estimated by the Congressional Budget Office and the CMS are explored. Finally, the report provides a timeline of CLASS program provisions enacted under PPACA.