Aging/Older Adults

To answer the question posed in the title, the authors studied HCBS spending and the availability of family members. Higher HCBS expenditures are found to be associated with lower risk of nursing home admission, but this association is statistically insignificant for older adults with living children. Doubling state HCBS expenditures would reduce the risk of nursing home admission among childless seniors by 35%.

The study examines the association of state HCBS expenditures with use of formal and informal personal assistance by Americans aged 70 and older with functional limitations. After controlling for other factors, the authors find that persons residing in states with higher HCBS expenditures were more likely to use formal personal assistance, but not less likely to use informal assistance. Data were from state expenditures and the Assets and Health Dynamics among the Oldest Old Survey.

New York spends more than most states on Medicaid and long-term care. To understand why this is, the following traits are evaluated: demographics of residents over 65; poverty level; long-term care spending, budgets, and services; and quality of nursing home care. The findings identify a number of demographic and program factors likely contributing to the high rate of spending.

Money Follows the Person (MFP) programs only target 0.9% of the people that could be eligible for transitioning out of institutions each year. However, there is a potential to increase rates to 15-40% annually depending on quality of program implementation, who is targeted, and how successful states are in overcoming barriers to transitioning high-needs people. The report looks at grantee states’ potential for accomplishing this rate increase.

Finding and enrolling older adults and adults with disabilities into benefit programs for which they may be eligible represents an enormous challenge to the agencies that serve them. This website provides tools and resources to these local, state and national agencies to assist them in helping their clients access benefit programs, along with information on best practices and cost-effective strategies for outreach and enrollment.

As part of this Act, requirements were instituted involving the state's ADRCs and the global budgeting process used to support them. The Act provides specific directives that address financing and management plans, implementation and operation of the Medicaid LTC expenditure reforms, and requires an annual report, one of which is also included here, that documents reallocation of funds to home and community based care.

For many years, Section 1115 waivers have been used in the Medicaid program and the Children’s Health Insurance Program, to provide states an avenue to test and implement coverage approaches that do not meet federal program rules. While these waivers have facilitated important program evolutions over time, some have also raised issues. This brief reviews the experience of Section 1115 Medicaid and CHIP waivers and discusses issues for the Obama administration to consider for the future.

Medicaid covers health and long-term care services for many millions of low-income Americans. Conversations were already underway at this event concerning the role of Medicaid as a vehicle for economic stimulus, and about health coverage expansion proposals, with particular discussion around the challenges facing states implementing the program in the recent economic downturn.

The question posed in the title is answered by analyzing state spending data from 1995-2005. The report shows that, for two distinct populations receiving long-term care services, spending growth was greater for states offering limited noninstitutional services than for states with large, well-established noninstitutional programs. Expansion of HCBS appears to entail a short-term increase in spending, followed by a reduction in institutional spending and long-term cost savings.

Trends of population, economics, health status, health risks and behaviors and health care are drawn from several governmental statistics sources. Over 38 indicators are complemented by a one-time special feature on health literacy. This is the fourth chart book prepared since 2000. Detailed tables are available as excel spreadsheets.