Medicaid Managed Long Term Care

In 2017, ADvancing States administered a survey of state agencies that deliver LTSS, including aging and disability agencies as well as Medicaid programs, regarding the significant policy, fiscal, and operational issues occurring within each state. During the survey, we collected detailed information about the structure of agencies, the supports provided, and the populations served by state programs.

This is the first major research paper in this emerging field of managed long-term services and supports (LTSS) that addresses family caregivers’ needs. Family caregivers of people with self-care needs often make it possible for the members of managed care plans to live at home rather than in institutions. Managed care plans, therefore, have strong financial incentives to support these family caregivers, thus improving quality of life and reducing the overall cost of care.

A national survey of Area Agencies on Aging is conducted every two to three years. The National Association of Area Agencies on Aging (n4a) has released their 2017 survey report. They surveyed 622 Area Agencies on Aging (AAAs), with 412 completing the survey, to discover what services they commonly offer, how AAAs address funding, and what their policy priorities are.

In recognition of a lack of reliable and robust information on the value of state managed long-term services and supports (MLTSS) nationally, this report aims to partially fill the gap with data and evidence from a survey of state agencies and a review of relevant outside research, and to also serve as a jumping off point for future study.

This report from Truven Health Analytics describes Medicaid long-term services and supports (LTSS) expenditures. The report shows federal fiscal year 2015 data, along with updates for FY 2012 through 2014 spending. Along with discussing trends in Medicaid LTSS expenditures, the report includes numerous data tables that summarize national and state-level expenditures by service category and state.

This brief, a product of the Complex Care Innovation Lab made possible by Kaiser Permanente Community Benefit, outlines the current state of Medicaid NEMT services, its challenges, and opportunities for improvement. It explores alternative transportation models piloted by states and health plans across the country, including the use of transportation network companies, such as Uber and Lyft, to augment NEMT services.

On February 8th, the Government Accountability Office publicly released a report on Medicaid managed care and Long-term Services and Supports. The report examined MLTSS program goals, payment structures, financial incentives for plans, and federal monitoring programs. The report makes several recommendations for CMS.

The Center for Health Care Strategies, Inc. released a technical assistance brief, funded through support by the Robert Wood Johnson Foundation, titled "State Medicaid Managed Long-Term Services and Supports Programs: Considerations for Contracting with Medicare Advantage Dual Eligible Special Needs Plans."

During calendar year 2015, ADvancing States engaged in a collaboration with the DentaQuest Foundation to identify and promote effective oral health interventions for older adults and people with physical disabilities. This initiative involved collaborating with partners from the dental, aging, and disability fields in order to increase knowledge regarding issues and challenges related to dental services for older adults and people with disabilities.

This report represents two years of work by the HCBS Committee and and contains the Committee's final set of recommendations. It describes key components of a conceptual foundation for home and community based services (HCBS) quality measurement, specifically an operational definition of HCBS, a list of characteristics describing high-quality HCBS, and a measurement framework of 11 domains and 40 subdomains.