Washington

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.

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.

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.

Are you developing a participant handbook for your Veteran-Directed Home and Community Based Services program? Review state examples from Maine, Massachusetts, Texas, and Washington. These participant handbooks provide an overview of the VDHCBS program, the assessment process, developing a person-centered plan and individual budget, legal responsibilities as an employer, working with a Financial Management Services vendor, and more.

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.

America's rural communities contain the nation's highest concentrations of older people. Learn about the results of a 13-year, $13-million national program created in 1992 by the Robert Wood Johnson Foundation and NCB Capital Impact to develop affordable assisted living models, with a focus on smaller and rural communities and low-income seniors. Learn about the strategy, program design, implementation, results and lessons learned.

Growth in the cost of long-term care services in the U.S. has slowed somewhat during the past two years. As home health care gains in popularity, however, costs are beginning to rise more rapidly and are expected to increase steadily over the next few years. Read about these trends and more in this 2010 study that looked at consumer perceptions and cost trends by state and key metropolitan areas.

This updated resource, the first reflecting a ten year perspective, provides a state‐by‐state look at wages and wage trends for PHCAs, the fourth fastest‐growing occupation in the country, and a key job title within the direct‐care workforce. Prepared as a resource guide on wages for advocates and policymakers, the data underscore the problem of low wages for PHCAs, factors which contribute to workforce instability and near‐poverty incomes for this workforce.