Medicaid Managed Long Term Care

The Long-Term Care Financing Collaborative released a final report detailing the consensus framework for long-term care financing reform. LTCFC offered recommendations for reforms to expand access to long-term services and supports (LTSS) for individuals with all financial backgrounds. The proposed changes include: Clear private and public roles for long-term care financing; a new universal catastrophic long-term care insurance program; and redefining Medicaid LTSS to empower greater autonomy.

The Center for Health Care Strategies (CHCS), in partnership with Mathematica Policy Research and Airam Actuarial Consulting, released an issue brief on the state considerations when setting capitation rates for Medicaid Managed Long-Term Services and Supports (MLTSS) programs. CHCS and its partners examined the considerations taken by eight states (Arizona, Kansas, Massachusetts, Minnesota, Tennessee, Texas, Virginia, and Wisconsin) as they established their MLTSS rates.

The White House released the final report from the White House Conference on Aging (WHCOA). President Barack Obama hosted the sixth WHCOA on July 13, 2015. Prior to the conference, events were hosted all over the United States to allow stakeholders to provide their input. The final report summarizes the work done both at the WHCOA and during the pre-conference activities and feedback elicited throughout the process.

The AARP Public Policy Institute published a report that examined what state Medicaid agencies need in order to effectively monitor the performance of managed long-term services and supports (MLTSS) programs. Eight states with long-term experience operating and overseeing MLTSS were used to analyze monitoring capacities and develop promising practices. The states were: Arizona, Massachusetts, Minnesota, New Mexico, New York, Tennessee, Texas and Wisconsin.

The Kaiser Family Foundation published an issue brief of the role of Medicaid for People living with dementia. Individuals with dementia generally require a multitude of medical and behavioral health services. Medicare covers some services for this population but there are gaps where Medicaid may need to fill in for payment of long term services and supports (LTSS) for low-income people. This brief includes a fact sheet for explain the role of Medicaid for people with dementia.

The annual 2013 Medicaid Managed Care Enrollment Report created by the Division of Managed Care Plans and the Data and Systems Group in the Center for Medicaid and CHIP Services at CMS, with assistance from Mathematica Policy Research, was released this week. Data on Medicaid enrollment is collected from every state, territory, and the District of Columbia, and is broken down into categories by program, population, and state. The report provides tables with nationwide data and data by state.

The Milbank Memorial Fund released a new study, the Role of State Medicaid Directors: A Leadership Imperative. This study was authored by Andy Allison, a former Kansas and Arkansas Medicaid Director. The study focuses on the current climate of Medicaid policy, organizations and leadership. There is a specific focus on how the administration is structured for Medicaid in the states and the adequacy of state investments in the role and compensation of these leaders.

The results of the annual survey represent a snapshot of the current status of state government employees, the agencies that administer the programs, and the services that are provided. The 2015 survey revealed that states are continuing to address the same underlying challenges discussed in the previous reports.The report also includes summary tables that outline specific information about each individual state agency and LTSS program. Email adiaz@advancingstates.org to request a hard copy version.

The Center for Health Care Strategies released a brief, funded by the Commonwealth Fund, that examined member engagement approaches used by participating health plans in Promoting Integrated Direct Care for Eligibles (PRIDE). The brief highlights promising strategies for providing Medicare-Medicaid enrollees with complex medical, behavioral health, and social service needs. There is a specific emphasis on the approaches to building trusting relationships with members.

The white paper examines the impact that managed care organizations can have on cost and quality of care for older adults and people with disabilities. The National Council on Disability found that MCOs can lower the costs of services for these populations. However, MCOs must face the challenge of training staff on person-centered planning and competency for the quality of care to genuinely increase. This provides an analysis of the positives and negatives of MCOs and where to move from here.