Managed Care

This brief includes the latest (FY 2018) Medicaid HCBS enrollment and spending data from KFF’s 18th annual 50-state survey. It contains data about per-enrollee spending on HCBS by target population and HCBS waiver waiting lists. This issue brief also includes tables with detailed state-level data. One key finding analyzed here is that most HCBS enrollees receive services provided at the state option.

This report is the fourth in a series of publications from the MLTSS Institute, which was established in 2016 to drive improvements in key MLTSS policy areas, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans. This issue brief focuses on delivering effective care to individuals eligible for both Medicare and Medicaid and aims to lay out the case for state Medicaid agencies to invest in integrated care programs.

The Home and Community Based Services (HCBS) Conference is hosted annually by ADvancing States (formerly known as NASUAD). This event highlights best practices from across the country in home and community-based services. The conference includes federal, state, and local policymakers as well as those who administer, manage, and deliver waiver and other HCBS programs. This link contains all of the slide presentations from the 2019 HCBS Conference.

This blog post discusses the concept of using value-based payment models in Managed LTSS. The post reviews the challenges of using VBP in HCBS and highlights lessons learned from CHCS' work with five MLTSS states.

This report is the third in a series of publications from the MLTSS Institute. The report identifies the challenges and promising practices in addressing the mismatch between supply and demand for direct care workers in long term services and supports programs, all viewed through the lens of MLTSS programs. This report is co-authored by ADvancing States and Sage Squirrel Consulting, LLC.

This brief highlights the importance of ongoing litigation around the ACA and discusses Medicaid demonstration waiver activities. It also addresses the recent passage of bi-partisan legislation with new tools and financing that states can use to strengthen their response to the opioid crisis. Finally, the brief reviews issues including Medicaid financing for Puerto Rico and USVI; Medicaid and public charge changes; and reforms in benefits, payment and delivery systems.

While healthcare payment systems are moving toward paying for value, the unique needs of individuals with I/DD and their families means that the transition toward alternative payment models (APMs) for Medicaid-funded services must be undertaken carefully. This white paper includes 14 payment reform principles to guide the development and assessment of new and emerging APMs for Medicaid I/DD services. The paper also includes 13 recommendations for current and future APMs for I/DD services.

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide presents a checklist of four issues for consideration as states identify issues to consider when developing and adopting value-based payment (VBP) models for HCBS within managed long-term services and supports (MLTSS) programs. The guide also reviews strategies for stakeholder engagement.

This report examines 40 Medicaid managed care contracts and 25 approved Section 1115 demonstrations. It identifies common themes across state approaches to incentivizing and requiring SDOH-related activities. CHCS also provides several additional policy recommendations for bolstering SDOH investment in state Medicaid offices.

This report is the result of a symposium held with approximately 25 thought leaders in the healthcare and LTSS industry. It also includes data analysis of 28 service agencies supporting 3,000 people with IDD. This report is intended to serve as a road map for key measures which would support people with IDD.