Long Term Services and Supports

On Wednesday, July 20, 2016, the Center for Health Care Strategies, Inc. (CHCS) published a new brief, “State Trends in the Delivery of Medicaid Long-Term Services and Supports.” With support from The SCAN Foundation, seven states (Arizona, California, Kansas, Minnesota, New Jersey, Tennessee, and Texas) were selected to provide insights into current trends in both managed long-term services and supports (MLTSS) program refinement and long term services and supports (LTSS) system reform.

On Friday, July1, 2016, Mathematica Policy Research published a report summarizing the basic approach to rate-setting in Medicaid managed care and reviews the main options for structuring managed LTSS (MLTSS) rates. It presents examples from states with financial alignment demonstrations as well as long-standing MLTSS programs. The report concludes by highlighting the policy and operational considerations that should influence a state’s choice of strategy.

Gary Sullivan, a member of UnitedHealthcare in Tennessee, shares his perspective on the benefits he’s received from being a UnitedHealthcare member. Gary, who was a practicing attorney until his retirement, has been wheelchair-bound due to his muscular dystrophy for many years, and has significant need for help with activities of daily living.

The Center for Policy and Evaluation, Administration for Community Living (ACL) published the policy brief “Promoting Community Living for Older Adults Who Need” in June, which marked the 17th anniversary of the Olmstead v. LC Supreme Court decision. The Olmstead decision has helped older adults and people with disabilities receive more integrated care; however, the policy brief outlines opportunities that states have to further improve their home and community-based services (HCBS).

The U.S. Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) issued new guidelines to assist long term care facilities in complying with regulations by the Centers for Medicare & Medicaid Services (CMS) that require facilities which are Medicare and/or Medicaid-certified to ensure their residents receive services in the most integrated setting appropriate to their needs.

The Department of Health and Human Services (HHS) published a report about the Minnesota Senior Health Options (MSHO) program. The Centers for Medicare and Medicaid Services (CMS) and the State of Minnesota started MSHO to coordinate the Medicare and Medicaid benefits their members receive, including Medicare coverage of acute medical care and Medicaid coverage of long-term services and supports. The report includes documentation of MSHO's outcomes from years 2010 to 2012.

On Wednesday, June, 15, 2016, the Medicaid and CHIP Payment and Access Commission (MACPAC) released the March 2016 Report to Congress on Medicaid and CHIP. The authorizing statute of MACPAC requires the commission to submit a report to Congress by March 15 and June 15 each year. The report discusses financial and spending analyses as well as functional assessment tools that Medicaid programs use to determine eligibility and create specific care plans.

Milbank Memorial Fund’s Reforming States Group partnered with The New York Academy of Medicine to develop sessions focused on some of the major challenges and opportunities facing states as they work to support an aging population. This report provides a review of the issues discussed at the meetings, as well as recommendations for state policy interventions. The report also focuses on topics of specific interest to state leaders: age-friendly communities; LTSS and workforce.

ADvancing States has released the association’s 2016 policy priorities. The priorities document outlines issues and recommendations regarding a wide range of health and human services programs important to older adults and people with disabilities. These include issues such as: • Implementation of the Older Americans Act reauthorization; • Medicaid LTSS innovations; • Support for caregivers; and • Employment for people with disabilities •

UnitedHealthcare Community & State released a White Paper unveiling a proposed quality framework for MLTSS programs. The framework, developed by UnitedHealthcare's National Advisory Board, extends beyond traditional clinical measures to measure the quality of the "services and supports" delivered in MTLSS, which is often most important for those accessing MLTSS benefits.