North Carolina

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.

To improve beneficiary care and reduce unnecessary expenditures, a number of states have developed programs and initiatives aimed at improving the coordination and management of care for dual eligibles—beneficiaries enrolled in both Medicaid and Medicare for their health care services. This report reviews the experiences in nine states to determine the lessons that can be learned from experience.

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.

Contained in this research report are the results from a survey conducted with adults receiving mental health services in North Dakota and professionals who administer mental health services. Reviewing this information may be helpful for agencies, policymakers, and advocates seeking to build on the current system of mental health services.

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.

To better understand the dynamics of the workforce challenges that factor in to the implementation of health reform, an initiative was undertaken to examine the situation in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington). These states represented a range of geographic and political experiences as they continued to struggle with the lingering impacts of the recession and began preparing to implement health reform. Six key findings are summarized.

Are you looking for state data on people who are simultaneously enrolled in Medicare and Medicaid? Find a number of useful interactive tables, charts, and graphs including Medicaid spending by service, spending per dual eligible, dual eligible enrollment, duals as a percentage of Medicaid enrollees, and more.

Unemployment of individuals with intellectual and developmental disabilities (ID/DD) continues to be a significant public policy concern. This report looks at statistics over a 20-year period from several national data sets that address the status of employment and economic self-sufficiency for this population, and contains an overview of national trends, an in-depth perspective on how states collect and use employment data, and an Appendix with individual state and national profiles.