Managed Care

The results of the annual survey represent a snapshot of the current status of state government employees, the agencies that administer the programs, and the services that are provided. The 2015 survey revealed that states are continuing to address the same underlying challenges discussed in the previous reports.The report also includes summary tables that outline specific information about each individual state agency and LTSS program. Email adiaz@advancingstates.org to request a hard copy version.

The white paper examines the impact that managed care organizations can have on cost and quality of care for older adults and people with disabilities. The National Council on Disability found that MCOs can lower the costs of services for these populations. However, MCOs must face the challenge of training staff on person-centered planning and competency for the quality of care to genuinely increase. This provides an analysis of the positives and negatives of MCOs and where to move from here.

The AARP Public Policy Institute released a new report conducted by Truven Health Analytics. The two part study examined Medicaid Managed Long Term Services and Supports program contracts in 18 different states for older adults and people with physical disabilities and case studies of new care coordination models in Ohio and Illinois. The findings indicate that states need care coordination and that these care coordinators provide crucial support for consumers and their family caregivers.

The U.S. Department of Health and Human Services report and the white paper commissioned by the National Interprofessional Initiative on Oral Health both examine the wide disparities in oral health due to lack of access. The U.S. fails to provide proper access for ongoing and preventative oral health care needs. A push must be made to integrate dental care as a component of primary care. There is also a focus on the impact and burden of oral diseases and their effect on quality of life.

Adult day services (ADS)--a non-residential service provided outside an individual's home for less than a full day--provides direct care to older adults and younger adults with physical disabilities. This report provides information about each state's approach to regulating this key community service. The report details different models, forms of regulation, and funding sources used by states to run ADS programs.

Person-centered planning encompasses the idea that the individual is at the heart of all decisions about services, supports, and care. This report analyzes how well states are implementing a 2014 rule that creates the right to person-centered care planning for Medicaid consumers of Long-Term Services and Supports. The report is a tool for health care providers, plan administrators, and advocates to help them understand the scope of the rules and be able to identify provision shortfalls.

Working together, housing and health care partners can launch initiatives that lead to improved health, safety, and quality of life for low-income older adults facing multiple health and social challenges. This guide outlines how housing and health providers can work together to make life better for older adults.

Healthcare providers, payers, and CBOs have historically operated as separate care delivery systems in which the responsibility for communicating and sharing information among providers has been on the client. A follow up to N3C's symposium at the 2014 ASA's Aging in America conference, this brief presents insights and actionable approaches that attempt to close the gap between fragmented and patient-centered care to evolve with the market and better provide for our communities.

As part of PHI's One Vision: Moving Forward project, Michigan long-term care stakeholders discussed the potential use of Medicaid financial incentives to encourage person-centered care in nursing homes.The resulting publication outlines the ideas and recommendations produced by the discussion. The stakeholders primarily considered metrics, such as resident and staff satisfaction, that could be used to quantify nursing homes' commitment to person-centeredness.

This GAO report examines (1) the extent to which Medicaid enrollees have private insurance, and (2) the state and CMS initiatives to improve third-party liability (TPL). Given the findings in the report, GAO recommends that CMS routinely monitor and share information regarding key TPL efforts and challenges, as well as provide guidance on state oversight of TPL efforts conducted by Medicaid managed care plans.