Aging/Older Adults

Shifting the balance in publicly-funded long-term care provision away from institutional care toward greater reliance on home and community-based services has been a federal goal for the past three decades -- a goal often referred to as "re-balancing" state LTC systems. This report explores inter-state variations in LTC expenditure and service use patterns, in terms of institutional and non-institutional services, and also by Medicaid LTC users' age and type of disability.

This report is a comprehensive account of the number of individuals in each state who received Medicaid-funded LTSS in calendar year 2010 based on the Medicaid Analytic eXtract (MAX). The MAX data source is a set of Medicaid administrative data files designed to facilitate Medicaid research. The report identifies the number of people by population group who received institutional and non-institutional services. With some exceptions, State and national data are included.

This report brings together available evidence on the effect of PACE on several key outcomes: Medicare and Medicaid costs, hospital and nursing home utilization, quality of care, satisfaction and quality of life, and mortality. The authors summarize findings from past studies and assess their methodological approach. They improve on these earlier evaluations by conducting a more detailed review of the studies, as well as a more rigorous assessment of the quality of evidence presented in each.

After a decade of changes in federal law, regulation, and policy designed to promote the growth of publicly funded participant-directed long-term services and supports (PD-LTSS) programs, the number of these programs has grown considerably. This article details the process for developing this data resource, describes some of the major characteristics of PD-LTSS programs in the United States, and discusses possible implications and areas for future research.

This white paper provides an inventory of all current MLTSS programs and a projection of future programs as of July 2012. The report includes state-by-state results and synthesizes findings across states, reporting national enrollment, characteristics of contractors and multiple program features.

This State Long-Term Services and Supports (LTSS) Scorecard is a multidimensional approach to measure state-level performance of LTSS systems that assist older people, adults with disabilities, and their family caregivers. This second edition of the State LTSS Scorecard measures LTSS system performance across five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions.

Medicaid LTSS is not a system that was purposefully built, but rather one that evolved over time out of legacy programs that were designed to meet the needs of different populations, differing state approaches to policy, court decisions, client advocacy, and changing ideas about where and how LTSS should be provided. MACPAC’s future work on Medicaid LTSS will focus on building a better understanding and moving policy in the direction of a more efficient and effective system of LTSS.

The Money Follows the Person (MFP) demonstration grant program helps long-term residents of institutions move back to the community. This report aims to answer several questions about the expenditures (medical care and long-term services and supports [LTSS] expenditures) of people who transition from institutional care to community-based LTSS.

This report summarizes audited Healthcare Effectiveness Data and Information Set (HEDIS) results for calendar year 2013. Data come from a record number of health plans -- 814 HMOs and 353 PPOs, representing more than 171 million people, or 54 percent of the U.S. population.

This report fulfills NCD’s statutory mandate to annually report and make recommendations concerning the state of disability policy in the United States. Specifically, the 2014 Progress Report focuses on seven key areas: the Convention on the Rights of People with Disabilities (CRPD), employment access and inclusion, subminimum wage, education outcomes, Medicaid managed care, mental health care, and data trends in disability policy.