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In an effort to improve care & reduce costs, states & the federal government are seeking new ways to provide services to people eligible for both Medicare & Medicaid. Missing from the discourse are the voices of these dual eligibles. Changes to the way their care is organized & delivered could have profound effects on their health, quality of life, & satisfaction. This project aims to complement state & federal efforts by offering perspectives on what duals want from their models of care.

This report is the latest in a series on expenditures for Medicaid waivers authorized under Section 1915(c) of the Social Security Act, also known as home and community-based services waivers. For the first time, the tables include state-reported data for 1915(c) waiver services provided through managed care programs that are not identifiable in the state CMS 64 reports. Thomson Reuters collected these data for FY 2008 and FY 2009.

This fourth and final report for the national evaluation of the FY05, 06, and 07 Real Choice Systems Change (RCSC) Grants presents findings for both FY05 and FY06 Systems Transformation (ST) grantees. The findings address how grant efforts progressed between initial and final implementation periods and whether those efforts resulted in the achievement of grant outcomes and ultimately transformation of state systems.

This document is the latest in a series of reports on Medicaid long-term services and supports (LTSS) spending. This year’s report contains newly available data and changes in the services that are included within LTSS. The report explains the changes, summarizes the data, and describes national trends.

Review this policy brief which summarizes 15 states' preliminary proposals to better coordinate care for people who are in the Medicare and Medicaid programs. The design contracts are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those of other Medicare and Medicaid beneficiaries.

Third Annual Report builds on findings from the first two Annual Reports and focuses on the progress grantees made during the 2008-2009 grant period, representing slightly different stages of implementation for the FY05 grantees (Year 4) and the FY06 grantees (Year 3). Across grantees, data on outcomes during 2008-2009 grant period remained limited and changes in system infrastructure continue to be difficult to assess at this time.

The estimated economic value of family caregivers’ unpaid contributions contribution was approximately $450 billion in 2009. If family caregivers were no longer available, the economic cost to the U.S. health care and long-term services and supports systems would increase astronomically. This report updates national and individual state estimates of the economic value of family care using the most current available data, and provides recommendations for taking care of the caregivers.

By 2015, more than 15.5 million Americans 65 and older will live in communities where public transportation service is poor or non-existent. That number is expected to continue to grow rapidly as the baby boom generation “ages in place” in suburbs and exurbs with few mobility options for those who do not drive. This report ranks metro areas by the percentage of seniors with poor access to public transportation, now and in the coming years, and presents other data on aging and transportation.

Since 1988, Thomson Reuters has produced annual reports on state Medicaid spending for long-term services and supports (LTSS). One limitation to the reports has been that LTSS spending provided through Medicaid managed care programs often is not identified. This report presents estimated Federal Fiscal Year 2008 and 2009 managed care spending not included in previous LTSS expenditures reports. These estimates are based on data provided by states with managed LTSS programs.

This report provides the latest national and state data on enrollment and spending for individuals enrolled in both Medicaid and Medicare, also known as dual eligibles. There were about 8.9 million dual eligibles in 2007. Dual eligibles are among the sickest and poorest individuals covered by either program. Although they comprised 15% of Medicaid enrollment, dual eligibles accounted for 39% ($121 billion) of Medicaid spending for medical services & for more than a quarter of Medicare spending.