All States/Territories

The coordination of Medicare and Medicaid benefits and services for dually eligible enrollees has been a longstanding policy challenge. Several provisions of the Affordable Care Act (ACA) attempt to address this lack of coordination. This paper reviews the major changes under the ACA directed at care coordination for the dually eligible population and then concludes with a discussion of the continuing legislative and legal challenges in integrating care for the dually eligible.

A statistical model was developed to assess the effect of rebalancing on overall spending for long-term services and supports (LTSS). The model indicates that spending is affected by the way rebalancing is implemented: Gradual rebalancing can reduce spending by about 15 percent over ten years. Because many states continue to experience budget crises, policy makers must think carefully before altering spending patterns for LTSS and adopt strategies to successfully reduce overall spending.

The results of the survey suggest that in the past three months, 39.8 million people (aged 15 and older) provided unpaid care. Starting last year, respondents were asked about caregiving. Almost a third of respondents reported taking care of two or more older people, and 23% also had a minor child in their households. The results also suggest that men caregivers are growing in numbers. The average time spent providing care was three hours, though women spend about an hour more than men.

This study addresses issues related to the provisions of home and community-based services (HCBS) under the Affordable care Act (ACA) legislation of 2010. ACA allowed important voluntary provisions for the expansion of HCBS under Medicaid. Although the new provisions are valuable, the law does not set minimum standards for access to HCBS, and the new financial incentives are limited especially for the many states facing serious budget problems.

States provide long-term care services in homes and community-based settings through 1915(c) home and community-based services (HCBS) waiver programs. To ensure strong oversight of waiver programs, this report reviews documents from CMS's most recent quality review of waiver programs from 25 States, as well as information gathered from structured interviews with staff from the 10 CMS regional offices. The report also identify five recommendations to meet assurances related to quality of care.

Supported by the Pew Home Visiting Campaign, NASHP conducted a scan of state policies and practices and convened an expert panel to identify mechanisms for supporting home visiting services through Medicaid. This report explores various Medicaid financing mechanisms states could use to support home visiting services and considerations for states exploring these financing options.

This document aims to guide providers of self-management education (SME) chronic condition programs in efforts to assure high-quality services are available over the long-term. This guide is a synthesis of practical experience and evidence-based strategies to help SME providers achieve sustainability. It provides a process for exploring critical issues in the areas of revenue, marketing, referral networking, service operations, evaluation, community support, advocacy, and resource linkages.

This policy brief describes the long-term care insurance (LTCI) industry; in particular, it provides overview information about who buys the product, how much it costs, what the market looks like, and how the government has promoted the purchase of the private LTCI. In addition, this brief covers a variety of topics, including barriers to expansion of private LTCI, the LTC partnership program, and international lessons from another highly-developed country (France).

The Toolkit was designed to help hospitals and community partners address the needs of people with chronic conditions by improving self-management skills. This toolkit provides information on the benefits of starting and sustaining a Chronic Disease Self-Management Program (CDSMP), helpful sources and materials implementing the CDSMP.

The first National Alzheimer’s Plan includes current federal activities and initial recommendations to expand, coordinate or condense programs to overcome Alzheimer’s disease. The plan was called for in the National Alzheimer’s Project Act (NAPA), which President Obama signed into law in January 2011. The National Plan sets forth five goals, including the development of effective prevention and treatment approaches for Alzheimer’s disease and related dementias by 2025.