Kaiser Family Foundation

Despite the current budget climate that has dampened the pace of some rebalancing efforts, 32 states expanded Medicaid long-term services and supports in FY 2010 (primarily expanding HCBS programs) and 32 states planned expansions for FY2011. This updated fact sheet provides an overview of long-term care services, delivery of such services, and the large role Medicaid plays in financing long-term care.

Key provisions of the reform law offer a blueprint for tightly-coordinated and consumer-friendly eligibility and enrollment systems with seamless coverage as their goal. This brief summarizes key requirements that states face to construct enrollment systems that help people understand their options, use electronic data-matching and online processes, ensure that people obtain appropriate coverage, and support seamless transitions between coverage in the Exchanges.

Millions of low-income adults without children who currently cannot qualify for coverage, as well as many low-income parents and children now covered through the CHIP program will become eligible for Medicaid. These programs are expected to cover an additional 16 million people by 2019. This brief provides the details of the benefit and cost-sharing rules that will govern the coverage available to newly-eligible adult Medicaid beneficiaries.

Innovative applications of technology in Medicaid are highlighted in this series of profiles from varying states. Louisiana, a pioneer in using “Express Lane Eligibility” (ELE) is examined in this report. ELE allows Medicaid and CHIP agencies to use eligibility findings from other public programs to identify, enroll, and recertify participants. Despite a 12% reduction in the Medicaid workforce over the last two years, the volume and quality of service has remained consistent.

Integral to the coverage framework laid out in the reform law is a dramatic expansion of the Medicaid program. This primer provides key information about the program today, including a definition of what it is, who and what services are covered, Medicaid expenditures and how they are financed, and information of how health reform reshapes the program for the future.

Find a concise summary of new opportunities under the health reform law for states to balance their Medicaid long-term care delivery systems by expanding access to Medicaid HCBS programs. The brief outlines key provisions of the new law that expand HCBS benefit options, broaden financial and functional eligibility criteria, and provide additional financial incentives for states to further shift their Medicaid long-term services budgets to non-institutional settings.

Find national and state by state estimates of the increases in coverage and the associated costs compared to a baseline scenario without the Medicaid expansions in health reform. Findings show there will be large increases in coverage and federal funding in exchange for a small increase in state spending. Since it is impossible to predict the behavior of each state, the analysis examines two participation rate scenarios differing in the strength of outreach and enrollment efforts.

Review an overview of federal priorities and recent trends in the field of prevention including descriptions of current initiatives in the public and private sectors, discussion of the potential role of ADRCs and other coordinated points of entry in health promotion and disease prevention programs, and sources of further information for program development. Also find a companion document that offers ten simple strategies that ADRCs can use to promote health and wellness.

Find an article produced for the general public discussing the progress of Money Follows the Person. The author cites study findings suggesting reasons for states’ slow movement in nursing home transition: problems finding affordable housing, resistance from nursing homes, stringent federal rules limiting eligibility and types of community settings individuals can move into. Included are links to a related video and interactive map showing each state’s goals and transitions made to date.

What are the major components of the Community Living Assistance Services and Supports (CLASS) program? The program establishes a national, voluntary insurance program for purchasing community living services and supports that is designed to expand options for people who become functionally disabled and require long-term help. Find a description of the program, including its financing, eligibility criteria, benefit design and interaction with Medicaid.