Medicaid Managed Long Term Care

KFF’s recent issue brief, “Who Uses Medicaid Long-Term Services and Supports?,” examines the characteristics of Medicaid enrollees who receive long-term services and supports (LTSS). LTSS can include assistance with activities of daily living (such as eating, bathing, and dressing) and instrumental activities of daily living (such as preparing meals, managing medication, and housekeeping). The issue brief also examines how individuals who use LTSS compare to those who do not use LTSS and how enrollees who use different types of LTSS differ from each other.

On June 7, Justice in Aging published an issue brief titled “An Equity Framework for Evaluating and Improving Medicaid Home and Community Based Services.” In recent decades, long-term care has shifted from institutional settings to home and community-integrated settings. While access to HCBS has been steadily increasing over time, systemic inequalities due to racism, sexism, ageism, classism, etc. have led to large disparities in HCBS for diverse communities. This issue brief evaluates several ways in which the current setup of HCBS can cause inequities to arise. This includes program design, provider availability, awareness of HCBS, implicit bias in services, and provision of HCBS...

Arnold Ventures has introduced a new project titled "Melissa & Ann: Navigating America's Tangled Health Care Safety Net," a compelling photo essay featuring the lives of two women living in Southern California who are dually enrolled in Medicare and Medicaid. Through the lens of award-winning photographer Isadora Kosofsky, this project sheds light on the daily triumphs, challenges, and complexities faced by older adults and people with disabilities navigating the health care system. By sharing these intimate stories, Arnold Ventures aims to inspire policymakers to prioritize improving care for the diverse population of low-income older adults and people with disabilities who are dual-eligible for Medicare and Medicaid.

KFF unveiled their “Medicaid Enrollment and Unwinding Tracker” featuring state-level Medicaid/CHIP enrollment data for the 50 states and the District of Columbia as well as any unwinding or monthly renewals, disenrollments, and other measures that may be available for states. The tracker also provides information on state-specific Medicaid renewal policies, eligibility policies, and system capacity measures. The tool includes national data on Medicaid enrollment as reported by the Centers for Medicaid and Medicare Services (CMS); however, these data lag by several months and do not provide a current picture of net changes in Medicaid enrollment.

On Tuesday, February 28th, CMS released the latest enrollment figures for Medicare, Medicaid, and CHIP. As of November 2022, over 65.3 million people are enrolled in Medicare; more than 35.1 million are enrolled in fee-for-service Medicare and over 30.2 have a Medicare Advantage plan. Over 91.7 million enrollees have Medicaid and CHIP; more than 84.8 million individuals have Medicaid and over 6.9 million have coverage through CHIP. Over 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.

On Tuesday, February 21, 2023 The Association of Community Affiliated Plans, Medicaid Health Plans of America, and Sellers Dorsey released their highlights from the 2022 State of Medicaid Managed Care Report. The report covered five core areas of managed care across the country, the current state of managed care, the history of federal regulations and key changes, effective approaches from six states, innovations and successes from MCOs, and outcomes stemming from managed care.

This past Tuesday, the Centers for Medicare & Medicaid Services (CMS) announce the latest enrollment figures for Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). As of October 24, 2022, over 65.2 million people are enrolled in Medicare, an increase of 132,757 since the last report. More than 35 million people are enrolled in Original or Fee-for-Service Medicare, and more than 30.2 million are enrolled in a Medicare Advantage or other health plan. Over 91.3 million enrollees have Medicaid (84.3+ million) and Children’s Health Insurance Program (CHIP) (7.0+ million), an increase of 462,322 since the last report. More than 12 million enrollees are eligible for both Medicare and Medicaid and are counted for both programs.

This blog post from Mathematica discusses the importance of partnerships between states and the federal government through highlighting topics covered at NAMD's 2022 conference. Sessions touched on innovations developed as part of recently approved 1115 demonstrations in Arizona, Massachusetts, Oregon, and Arkansas which focused on the ways states are providing whole-person care by addressing the health-related social needs of members. The post also explores Mathematica's work with CMS and states to build stronger measurement and evaluation infrastructure for a broad range of demonstrations, including those addressing substance use disorder, mental illness, and health-related social needs.

JAMA researchers found lower service use and lower Medicaid spending among the Black population for both during a review of health care spending statistics between White and Black Medicaid enrollees. Medicaid beneficiaries make up a diverse population, yet existing disparities persist. To explore differences in Medicaid spending between Black and White populations, researchers conducted a cross-sectional study using data from three states in 2016. Researchers used data from 1,966,689 enrollees in the study, including both adults and children. Of this population, 867,183 identified as non-Hispanic Black, and 1,099,506 identified as non-Hispanic White.

Prior to COVID-19, Indiana hosted stakeholder workgroups to identify needed improvements to its Medicaid-funded long-term services and supports (LTSS) system. The pandemic amplified existing disparities, including inequitable access to community-based care, unaligned and uncoordinated care for dually eligible individuals, and broad gaps in capacity and resources to effectively oversee and implement the LTSS reform effort. With support from Arnold Ventures, Indiana’s Family and Social Services Administration (IN FSSA) is working with project partners to design a Medicare-Medicaid integration strategy for dually eligible individuals enrolled in MLTSS and engage providers in its development process.