Medicaid

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.

The Financial Alignment Initiative (FAI) is intended to improve the quality of care and reduce spending for low-income people who are dually eligible. Mathematica researchers conducted a study to identify reasons for the varying participation rates across states. This brief explores the details of two major factors: passive enrollment and demonstration/MLTSS alignment.

CMCS has released the FFY 2018 Adult Core Set data. This data set provides information on 23 adult measures voluntarily reported by states. Recently released publications include an overview of 2018 findings, a core set chart pack, a summary of performance on measures, and the 2018 quality measures dataset.

CMCS has released the FFY 2018 Child Core Set data. This data set provides information on 23 child measures voluntarily reported by states. Recently released publications include an overview of 2018 findings, a core set chart pack, a summary of performance on measures, and the 2018 quality measures dataset.

The Home and Community Based Services (HCBS) Conference is hosted annually by ADvancing States (formerly known as NASUAD). This event highlights best practices from across the country in home and community-based services. The conference includes federal, state, and local policymakers as well as those who administer, manage, and deliver waiver and other HCBS programs. This link contains all of the slide presentations from the 2019 HCBS Conference.

This blog post discusses the concept of using value-based payment models in Managed LTSS. The post reviews the challenges of using VBP in HCBS and highlights lessons learned from CHCS' work with five MLTSS states.

This technical assistance tool focuses on the new “information sharing” requirement for Dual Eligible Special Needs Plans beginning in 2021. The tool explains the new requirement as well as how to address the requirement in mandatory D-SNP contracts.

This infographic provides information on coverage and costs for low-income Medicare beneficiaries. The resource describes people on Medicare, financial needs among beneficiaries, programs supporting low-income beneficiaries, and ways to improve access.

This fact sheet from the AARP Public Policy Institute takes a closer look at LTSS, revealing insights and new information, such as: what LTSS encompass, who needs LTSS, who provides LTSS, and where people with LTSS reside.

The Centers for Medicare & Medicaid Services issued a State Health Official letter that provides guidance on legislative changes to the modified adjusted gross income (MAGI)-based methodologies used for determining Medicaid and CHIP eligibility. In order to implement the changes to MAGI-based methods, states may need to update eligibility policies and procedures and make changes to eligibility systems logic.