Washington

Published monthly, this report and website tool focuses on state actions in managed care for people who receive Medicaid-funded LTSS and on state initiatives relating to services and costs. The Tracker includes updates on State Demonstrations to Integrate Care for Dual Eligible Individuals, the Balancing Incentives Payment Program (BIPP), states developing or implementing Medicaid State Plan amendments under §1915(i), and states pursuing the Communities First Choice Option under §1915(k).

Review a new survey of organizations that provide services within the I&R/A Network. The following themes emerged from the survey: aging and disability networks continue to integrate; the use of technology in I&R/A service delivery is slow to develop; the role of I&R/A organizations is expanding; and there are opportunities for improved coordination and quality service delivery. Review the recommendations that address these themes.

The recession continues to affect state programs for older individuals and adults with physical disabilities. Demand for publicly funded services has grown, and resources, including staff, are stretched thin, according to this new 50-state study. 31 states have cut non-Medicaid aging and disability services programs in FY 2010, and 28 states were expecting to cut these programs in FY 2011. Find the research report, brief, video and compiled State profiles.

This innovative disability and health data tool uses data from the Behavioral Risk Factor Surveillance System (BRFSS) to identify disparities in health between adults with and without disabilities. Find data on a range of health indicators for your state and compare the health of adults with and without disabilities and certain health conditions. Maps, data tables and state profiles are available.

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.

Few employer-sponsored and private insurance plans offer the range of services that workers with disabilities may need. Medicaid Buy-In programs are a viable option that allows these workers to receive needed services without spending down for Medicaid. This report describes findings from a study of characteristics and service utilization of higher-income enrollees compared to regular Medicaid enrollees. Providing these programs may keep higher-income workers with disabilities employed.

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.

This policy brief provides a comparison of CMS’ finalized memoranda of understanding with California, Illinois, Massachusetts, Ohio, and Virginia to test a capitated model and with Washington to test a managed fee-for-service (FFS) model to integrate care and align financing for dual-eligibles. These 2013 demonstrations will introduce changes in the care delivery systems and will test a new system of payments and financing arrangements among CMS, the states and providers.

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.