Aging/Older Adults

This issue brief reviews the structure of the prescription drug benefit in Medicaid and the traditional policy levers states have used to control drug spending. It also describes state strategies to contain costs, such as efforts to obtain greater rebates, actions concerning generic drugs and biosimilar alternatives, transparency laws and new efforts to draw on federal resources.

Older adults are affected by the opioid public health emergency because they often use prescription opioids to cope with painful chronic conditions or procedures. This issue briefing provides a summary about the problem, treatments, federal strategies to address the crisis, and funding and programs that are addressing this issue. The briefing also highlights innovative programs to address the opioid public health emergency in Arizona, Colorado, Nevada, and New Hampshire.

This report examines state and federal oversight of assisted living services in Medicaid. Individuals receiving long-term care services from Medicaid in community residential settings is expected to grow. This report describes state spending on and coverage of these services; describes how state Medicaid agencies oversee the health and welfare of beneficiaries in these settings; and examines the extent that CMS oversees state Medicaid agency monitoring of assisted living services.

This report from the Kaiser Family Foundation addresses Medicare beneficiaries’ out-of-pocket health care spending. This report highlights the rising medical costs for low-income older adults. It is estimated that by 2030, Medicare beneficiaries will be spending half of their Social Security benefit on out-of-pocket Medicare expenses.

This report outlines concrete steps to protect vulnerable Social Security beneficiaries and recipients. The report includes recommendations for Congress, the Office of Management and Budget and SSA to strengthen the current administrative process, create better monitoring and explore comprehensive, government-wide coordination and cross-agency reform of rep-payee processes.

This resource identifies key challenges related to oral health care access and utilization for low-income adults, and outlines states’ current coverage of dental benefits for adults in Medicaid.

The Government Accountability Office (GAO) examined states’ needs assessment processes for provision of long-term services and supports. GAO studied six states that differed in the following ways: assessment tools in use, participation in federal initiatives, HCBS delivery systems, and geographic location. GAO also reviewed federal requirements and documents and interviewed CMS officials and stakeholders.

The Center for Health Care Strategies (CHCS) and Manatt Health has developed a new toolkit that provides a targeted menu of long-term services and supports (LTSS) reform strategies adopted by state innovators that may be replicated by other states. The toolkit identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance their LTSS reforms.

Building Complex Care Programs: A Road Map for States is a guide for state leaders in establishing and advancing complex care programs. This guide from the National Governors Association Center for Best Practices (NGA Center) Health Division includes lessons learned from their work with states and effective practices gleaned from multiple pioneering state and local complex care initiatives.

This report presents the findings and conclusions of this national evaluation of the MFP demonstration. The MFP Rebalancing Demonstration program launched more than nine years ago. There are 44 grantee states, and as of the end of calendar year 2015, grantee states had transitioned a total of 63,337 Medicaid beneficiaries from long-term institutional care to community residences and home and community-based LTSS.