Long Term Services and Supports

This webinar discussed two issue briefs from the MLTSS Institute on aligning Medicare and Medicaid for dually eligible individuals. The briefs covered were, "Starting from Square One: Considerations for States Exploring Medicare-Medicaid" and, “The Value of Integration to State Medicaid Agencies”. The webinar also highlighted the perspective of the District of Columbia, which is planning to launch new program elements to better integrate care.

The Community Living Policy Center (CLPC) released a brief describing how short-term extensions of the Money Follows the Person (MFP) program have curtailed state efforts in transitioning individuals out of institutions. The CLPC based their findings on CMS data on annual transitions in each state.

This issue brief from the MLTSS Institute focuses on aspects of delivering effective care to individuals eligible for both Medicare and Medicaid. Only about 2/3 of states have undertaken any activity to better integrate care for dually eligible beneficiaries; many have encountered a number of barriers in pursuing better integration of the Medicare and Medicaid programs. This issue brief identifies key questions that states should ask themselves before they design an integrated care program.

This AARP Public Policy Institute research report examines support for family caregivers in managed long-term services and supports. The report finds that states have made progress in this area, but have opportunity to continue improving support for family caregivers in their MLTSS programs. One potential solution suggested by the report is to ensure that MLTSS contracts between states and health plans include clearly defined requirements to identify and support family caregivers.

On March 3, 2020, the Government Accountability Office (GAO) released a report that details challenges the Department of Veterans Affairs (VA) faces in meeting growing demand for long-term care (LTC). Three major challenges the VA faces includes workforce shortages, ailing care geographically, and meeting needs for specialty care. The VA currently provides or pays for LTC for over 500,000 veterans in the U.S. in both institutional and HCBS settings.

This issue brief discusses state policy trends using data from KFF’s 18th annual 50-state survey. It discusses policy areas such as implementation of electronic visit verification and value based payment models. The brief highlights key findings across the topics areas of HCBS program flexibility, MLTSS, and response to federal regulations

This brief includes the latest (FY 2018) Medicaid HCBS enrollment and spending data from KFF’s 18th annual 50-state survey. It contains data about per-enrollee spending on HCBS by target population and HCBS waiver waiting lists. This issue brief also includes tables with detailed state-level data. One key finding analyzed here is that most HCBS enrollees receive services provided at the state option.

This brief highlights the efforts of states who implemented Value Based Payment initiatives within systems that support individuals with intellectual or developmental disabilities (I/DD). The brief emphasizes the importance of understanding the population and provides an overview of the population served and their length of engagement with the service system. It looks at the experiences of OH and WA in the Medicaid Innovation Accelerator Partnership program from April 2018 to September 2019.

This case study explores how health plans can help rebalance LTSS for dually eligible members. It looks at two California health plans who successfully transitioned dually eligible members from institutional to community settings. The case study uses these two examples to identify key elements for supporting dually eligible individuals with LTSS needs during the transition to living in the community.

This report is the fourth in a series of publications from the MLTSS Institute, which was established in 2016 to drive improvements in key MLTSS policy areas, facilitate sharing and learning among states, and provide direct and intensive technical assistance to states and health plans. This issue brief focuses on delivering effective care to individuals eligible for both Medicare and Medicaid and aims to lay out the case for state Medicaid agencies to invest in integrated care programs.