Aging/Older Adults

CMS created a financial alignment demonstration to better promote coordinated care for dual-eligibles. The fee-for-service managed care model has received less attention than capitated managed care. However, this model could be useful in states or regions where traditional managed care organizations are not well established or do not function well. This brief makes some assessments of the advantages and difficulties of the model and identifies elements necessary for successful implementation.

CMS has released two important documents that outline essential elements of MLTSS programs that are in line with current best practices. The first document summarizes these essential elements and the second provides guidance for incorporating these essential elements into MLTSS programs operating under section 1115 or 1915(b) authorities. These standards will be used when CMS reviews states’ design, implementation and operation of MLTSS programs for approval and ongoing quality assurance.

Money Follows the Person (MFP) federal grants are provided to states in order to assist older adults and people with disabilities in transitioning from nursing facilities to home and community based settings. A history and current state of MFP are offered. This report provides an overview of how MFP has helped states to rebalance their LTSS programs and provides next steps and an outlook for the future of MFP or similar programs once the demonstration project’s funding has run out.

A survey of state aging, disability and Medicaid agencies was conducted in 2012, in order to better understand challenges and concerns for funding and providing quality LTSS. Five common themes were identified in this report, including staff turnover and reductions during a sluggish recovery of state budgets. Other findings include an overall expansion of home and community-based services, LTSS transformation and reduced funding and high demand for non-Medicaid aging and disability services.

Curious about issues of family caregiving and the workplace? This report highlights three public policy solutions to extend protections for working caregivers and reduce worker turnover: unpaid family and medical leave, paid family and medical leave insurance, and earned sick time. It presents an overview of each policy area, explains why workplace leave policies matter, and highlights states and localities that have adopted these protections.

Ethnic minorities and LGBT older adults will continue to become more represented among the older adult population. A lifetime of discrimination has often adversely affected LGBT elders of color in a myriad of ways, including greater likelihood of financial instability and heightened health disparities. This report offers policy solutions to support the wellbeing of this growing population. Policy solutions include strengthened outreach and community supports to LBGT elders of color.

The Affordable Care Act authorized the Medicaid Health Home State Plan Option, which allows states to design health homes to provide comprehensive care coordination for Medicaid beneficiaries with chronic conditions. States will receive enhanced federal funding to support the rollout of this new integrated model of care. This link directs to the Health Home Resource Center that provides technical assistance services for states as they submit their proposals for these health homes to CMS.

A representative sample of 1,019 adults ages 40 or older were interviewed regarding their experiences and beliefs about their need for long-term care services, what such care would cost, and how such issues fit into their concerns about growing older. This report outlines survey findings. Findings include, 58% of participants underestimate the cost of nursing homes, 41% have discussed long-term care preferences with family and 51% support a government sponsored long-term care insurance program.

This annual summary uses information from the US Census Bureau, the National Center for Health Care Statistics, and the Bureau of Labor Statistics to display the demographic shift, as well as the health, geographic distribution and economic changes of those over 65 in the United States. This report found that 13.3 percent of the population is 65 and older, but this demographic is expected to grow to 21 percent by 2040. Changes from previous summaries are analyzed and projections are made.

This report examines the importance of Medicaid as a safety net for financing long-term services and supports (LTSS). Most older adults will require some form of LTSS, but paid LTSS can be very expensive. Unpaid, family caregiving has enormous economic value and currently accounts for the greatest portion of LTSS provision. However, if an individual needs paid LTSS, and can't afford LTSS insurance, Medicaid is often needed after an individual spends down their assets.