Medicaid Managed Long Term Care

The AARP Public Policy Institute released a new report conducted by Truven Health Analytics. The two part study examined Medicaid Managed Long Term Services and Supports program contracts in 18 different states for older adults and people with physical disabilities and case studies of new care coordination models in Ohio and Illinois. The findings indicate that states need care coordination and that these care coordinators provide crucial support for consumers and their family caregivers.

The UnitedHealth Center for Health Reform and Modernization released a new brief. Many Americans do not have health insurance coverage, and Medicaid enrollment can cover the gap of the uninsured, if successful practices are used. This brief highlights four approaches used in Kentucky and Arkansas to increase enrollment for low-income residents to cut their uninsured populations in half. The solutions in this brief can inform other states on efforts to decrease the number of uninsured people.

The second annual report to Congress examines the services utilized by Medicaid's behavioral health beneficiaries. The findings indicate that low-income children have high levels of unmet need in the mental health care arena. Additionally, the review of Medicaid's dental coverage found considerable variation between states, particularly for services provided to adults. The report findings illustrate the potential directions for change to improve care for beneficiaries.

Person-centered planning encompasses the idea that the individual is at the heart of all decisions about services, supports, and care. This report analyzes how well states are implementing a 2014 rule that creates the right to person-centered care planning for Medicaid consumers of Long-Term Services and Supports. The report is a tool for health care providers, plan administrators, and advocates to help them understand the scope of the rules and be able to identify provision shortfalls.

These are three case studies of LTSS services in Minnesota, Idaho, and Georgia done by the Public Policy Institute of AARP as follow-up studies to the Raising Expectations 2011 State Scorecard on LTSS. The State LTSS Scorecard examines states' performance across 25 indicators that comprise four key dimensions of a high-performing system.

As part of PHI's One Vision: Moving Forward project, Michigan long-term care stakeholders discussed the potential use of Medicaid financial incentives to encourage person-centered care in nursing homes.The resulting publication outlines the ideas and recommendations produced by the discussion. The stakeholders primarily considered metrics, such as resident and staff satisfaction, that could be used to quantify nursing homes' commitment to person-centeredness.

Despite states' rebalance of long-term care (LTC) systems with greater emphasis on home and community-based services (HCBS), many low-income elderly, persons with physical disabilities, and persons with intellectual/developmental disabilities continue to reside in institutions. Through an analysis of Medicaid enrollment and LTC claims data, this report provides information on the characteristics of institutionalized enrollees, their stays, and the interaction of institutional services and HCBS.

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 paper identifies the concerns and considerations in transitioning traditional LTSS providers from fee-to-service models to a managed care program.The findings of the study are based on qualitative interviews conducted with a variety of stakeholders, including state Medicaid program officials, representatives from managed care companies, LTSS providers, LTSS provider associations, and private consultants.

This tool promotes consumer-focused MLTSS by making it easier to identify weaknesses and promote better practices. The tool combines a checklist for assessing MLTSS with examples of practices, policies or contract language that implement the criteria.