Medicaid Managed Long Term Care

ADvancing States is pleased to announce the release of a new issue brief, Addressing Nursing Facility Financing Challenges during MLTSS Program Development developed in collaboration with Milliman. This brief is intended to shed light on the complex and often-misunderstood relationship between nursing facility financing and Medicaid delivery system design.

In this blog post, Nancy Archibald, MHA, MBA, Associate Director of Integrated Care at CHCS, describes the state of Indiana's plan to launch Medicaid managed long-term services and supports in 2024. The state is receiving grant funding through Advancing Medicare & Medicaid Integration, an Arnold Ventures initiative developed in partnership with CHCS that assists states in filling resource gaps in designing and launching integrated care programs.

This report explores the role played by managed care organizations delivering Medicaid long term services and support programs during the COVID-19 pandemic. The report looks at the roles and responsibilities of governments, nursing homes, and MLTSS plans and argues their role in the pandemic response as well as the role of federal funding and data use, should all be examined further to inform future policy.

CMS has released a Center Informational Bulletin providing tools to states and CMS to improve the oversight of managed care and increase beneficiaries’ access to care. In the bulletin, CMS shares resources to improve compliance with managed care standards and requirements and guidance setting the content and format of the Annual Managed Care Program Report. The bulletin also outlines multiple tools and resources for improving managed care oversight that are currently in development at CMS.

On January 19th Centers for Medicare & Medicaid Services (CMS) released the Medicaid LTSS Annual Expenditures Report for Federal Fiscal Years (FFY) 2017 and 2018. This report discusses the LTSS rebalancing trends and growth in expenditures for home and community based services (HCBS) as compared to institutional spending during these select years.

The AARP Public Policy Institute recently launched a three-year initiative which aims to transform long term care in the United States. LTSS Choices will be a series of reports, blogs, videos, podcasts, and virtual convenings that seek to catalyze reform and spark ideas to modernize LTSS, long term services and supports. The goal is a long-term care system that provides a wide range of choices to meet the dynamic needs and preferences of consumers and their families.

CMS released an update to the COVID-19 Vaccines Toolkit that was released on 10/28/20 and first updated on 11/23/20. This update includes more information on vaccine administration reimbursement and outlines a streamlined review process available to states looking to quickly adjust vaccine administration reimbursement rates in state plans. The toolkit also provides more clarification on managed care network adequacy and the phased distribution and administration approved COVID-19 vaccines.

The Medicaid and CHIP Payment and Access Commission (MACPAC) released the 2020 edition of the MACStats: Medicaid and CHIP Data Book, with updated data on national and state Medicaid and State Children’s Health Insurance Program (CHIP) enrollment, spending, benefits, and beneficiaries’ health, service use, and access to care. MACStats brings together the range of Medicaid and CHIP statistics, including eligibility and enrollment, benefits, service use and access to care.

ACL and the Lewin Group released a report highlighting key takeaways from the AARP 2020 LTSS State Scorecard on state efforts in establishing high-performing ADRC/NWD systems. The report compares current data with results from the 2017 LTSS State Scorecard. The report provides scores based on five domains in ADRC/NWD system functions. The report also shares promising practices/lessons learned from five states – Alabama, Georgia, Massachusetts, Ohio, and South Dakota.

ATI Advisory released extensive data analysis of Medicare claims data to highlight the disparate impact of the COVID-19 pandemic on individuals eligible for both Medicare and Medicaid (dual eligibles).The analysis also offers policy pathways for states to improve integrated care for this vulnerable population.