New York

This issue brief uses the most recent comprehensive data, from 2009, to examine the characteristics and costs of dual-eligible beneficiaries. The report also examines the different payment systems that Medicare and Medicaid use to fund care for dual-eligible beneficiaries and recent efforts at the federal and state levels to integrate those payment systems and coordinate the care between both programs. Given the high cost of dual-eligibles, legislative solutions are reviewed.

The effective management of patients' complex illnesses across providers, settings, and systems places extraordinary demands on primary care providers, especially those that work in resource-limited small or rural practices. This issue brief identifies eight states that have adopted strategies to build practice capacity to care for high-need Medicaid beneficiaries through the development of community health teams and reports early data to inform other states thinking about this model of care.

In an effort to assist state agencies in planning for the specific behavioral health needs of emerging populations in their state, this toolkit provides state and national estimates of behavioral health disorders and program utilization, as well as step-by-step instructions to generate projections of health benefits, services and providers that will need to be addressed in the future. This resource can be helpful for mental health and substance use agencies, health plans, and Medicaid agencies.

The Census Bureau created the supplemental poverty measure, in an effort to differently reflect cost of living and financial status from the "official" measure. Poverty rates among older adults are higher under the supplemental poverty measure (15%) than under the official poverty measure (9%). This analysis does a state-by-state comparison using both poverty measures to describe seniors living in poverty. An understanding of elder financial hardship is important for fiscal policy debate.

CMS created a financial alignment demonstration to better promote coordinated care for dual-eligibles. The fee-for-service managed care model has received less attention than capitated managed care. However, this model could be useful in states or regions where traditional managed care organizations are not well established or do not function well. This brief makes some assessments of the advantages and difficulties of the model and identifies elements necessary for successful implementation.

A survey of state aging, disability and Medicaid agencies was conducted in 2012, in order to better understand challenges and concerns for funding and providing quality LTSS. Five common themes were identified in this report, including staff turnover and reductions during a sluggish recovery of state budgets. Other findings include an overall expansion of home and community-based services, LTSS transformation and reduced funding and high demand for non-Medicaid aging and disability services.

This report describes research conducted on the continuity of enrollment of Medicaid beneficiaries. Continuous enrollment in a health insurance plan promotes chronic disease management and is more cost-effective. The research found that Medicaid beneficiaries are on average enrolled in the program for just 9.7 months out of the year. This disruption in enrollment leads to higher monthly medical costs and interferes with efforts to measure quality of care delivered through Medicaid.

This annual summary uses information from the US Census Bureau, the National Center for Health Care Statistics, and the Bureau of Labor Statistics to display the demographic shift, as well as the health, geographic distribution and economic changes of those over 65 in the United States. This report found that 13.3 percent of the population is 65 and older, but this demographic is expected to grow to 21 percent by 2040. Changes from previous summaries are analyzed and projections are made.

This checklist prepared by the National Academy for State Health Policy (NASHP) highlights the ACA Medicaid requirements that will take effect in the next two years, nearly all of which will apply to states regardless of whether the state chooses to expand Medicaid eligibility.

What are the current realities, practices and needs of the I&R field? The Version 7.0 of the AIRS Standards is a comprehensive upgrade to the guide that offers foundation and credentialing outlines. Some of the changes from the previous version are relatively minor such as modifications in the wording of the Standard or relocation of a Quality Indicator to another Standard, to add clarity. In addition to these changes, there is the creation of a new Technology Standard (Standard 25).