Kaiser Family Foundation

In 2005, VT became the first state to commit to a federal Medicaid funding cap in exchange for expanded eligibility definitions and access to home and community-based services under a Section 1115 waiver. Case studies and interviews are used to present key findings from the program. Key design features are also presented. Finally, future issues within VT and other states that might emulate the program are discussed.

This is the eighth consecutive year that state Medicaid officials were surveyed to track program trends. In addition to data on expenditures and enrollment, the report outlines policy enhancements and restrictions in all states and the District of Columbia. The resource ends with a discussion of current key Medicaid issues and perspectives of State Medicaid Directors.

The Kaiser Commission on Medicaid and the Uninsured supported this focus group project of adults with disabilities in 4 states, who are enrolled in Medicaid Consumer Directed Personal Assistance Services programs. This research was undertaken to learn about Medicaid enrollees’ experiences in the program and their opinions about key features of the program including recruitment issues and degree of responsibility over services. Ways to improve upon the programs were also identified.

Consumer direction of personal assistance services (CD-PAS) is one model of service delivery that gives Medicaid beneficiaries varying degrees of control over hiring, scheduling, training, and paying personal care attendants. Program administrators, experienced with the programmatic features of CD-PAS in their state, were interviewed. Eligibility criteria, participant support services, and method of financial management used by Medicaid beneficiaries to pay direct care workers are discussed.

The national percentage of Medicaid spending on home and community-based services (HCBS) has more than doubled from 1992 to 2004. This report presents a summary of the main trends to emerge for the three Medicaid HCBS programs and the results of a survey of policies such as eligibility criteria and waiting lists.

According to a report by the Kaiser Foundation, Medicaid has become the major payer for long-term services and supports to low-income individuals, and a safety-net for those who become impoverished as a result of long-term care needs. In addition to concerns about the high costs of long-term care, recent developments have drawn attention to challenges facing Medicaid as a provider of long-term care. This paper describes these challenges and other issues facing the Medicaid program going forward.

The annual 50-state survey of state officials on Medicaid and state budget actions reports enrollment in Medicaid declined. This decline was driven primarily by two factors. States reported new citizenship documentation requirements were causing delays in processing applications, affecting individuals already eligible for the program. State officials also cited good economy and lower unemployment for reducing enrollment. 42 states expect to expand coverage to the uninsured in the next year.

Need an overview of the basic components of the nation’s largest health coverage program? Medicaid covers 55 million low-income individuals and is the dominant source of long-term care financing. Examine the structure of the program, who it covers, what services it provides, and spending. Because Medicaid is jointly financed by the federal and state governments programs vary across states. Tables examining the state-to-state variation in eligibility, enrollment, and spending are included.

States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. This report describes 10 operating individual budget model programs that serve older persons and identifies four areas of program design that are of particular importance to the success of the individual budget model.

The annual 50-state survey of Medicaid officials finds an improved economy combined with the implementation of the new Medicare prescription drug benefit has contributed to the lowest rate of Medicaid spending growth in a decade and the fourth consecutive year in which Medicaid spending growth has slowed. Review the news release, read the report, or listen to conference materials and view the presentation slides.