Medicaid

This report highlights Medicaid waiver policies that could result in many people losing coverage, even as states incur greater costs. This report offers a detailed assessment of emerging waiver trends, providing insights into its critical implications. The report also describes how examining the research literature and evaluations of programs that impose similar policies can provide guidance on predicting the coverage and cost impacts of emerging waivers on Medicaid beneficiaries and states.

This issue brief highlights Medicaid HCBS enrollment and spending data from the Kaiser Family Foundation's 17th annual state survey. The report found that nearly all Medicaid HCBS enrollment (86%) and spending (93%) went to services provided at state option. This optional nature of most HCBS covered populations and services puts individuals at risk of losing services if the current structure of Medicaid financing were to change.

This toolkit summarizes LTSS reform strategies adopted by state innovators. It identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance LTSS reforms. It also includes specific case studies and advice for other states looking to implement similar reforms. In addition, CHCS has published a brief for state legislators looking for a summary of options for developing LTSS policies.

This issue brief discusses the pressing legal needs of older adults and the ways that coordinating health care, legal, and social services can improve their well-being. The brief examines three medical-legal partnership programs serving older adults and explores their impact, including the prevention of homelessness and the improvement of financial stability.

This paper focuses on how state-funded home and community-based services programs can support low-income older adults. It highlights promising practices that support maximum independence for low-income older adults and/or people with physical disabilities and their family caregivers. The paper explores programs across nine states, including Washington state’s emerging innovation: the Medicaid Transformation demonstration.

The Centers for Medicare & Medicaid Services released their monthly report for November 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

This study analyzes the financial burden experienced by people who require long-term services and supports. The study analyzes medical and LTSS spending among older Medicare beneficiaries, particularly the costs of assistive devices and personal care. The results show that for medical services covered by Medicare, beneficiaries with a high need for long-term services spend more than $2,700 a year out of pocket on average, twice as high as those without such need.

This brief highlights the importance of ongoing litigation around the ACA and discusses Medicaid demonstration waiver activities. It also addresses the recent passage of bi-partisan legislation with new tools and financing that states can use to strengthen their response to the opioid crisis. Finally, the brief reviews issues including Medicaid financing for Puerto Rico and USVI; Medicaid and public charge changes; and reforms in benefits, payment and delivery systems.

While healthcare payment systems are moving toward paying for value, the unique needs of individuals with I/DD and their families means that the transition toward alternative payment models (APMs) for Medicaid-funded services must be undertaken carefully. This white paper includes 14 payment reform principles to guide the development and assessment of new and emerging APMs for Medicaid I/DD services. The paper also includes 13 recommendations for current and future APMs for I/DD services.

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide presents a checklist of four issues for consideration as states identify issues to consider when developing and adopting value-based payment (VBP) models for HCBS within managed long-term services and supports (MLTSS) programs. The guide also reviews strategies for stakeholder engagement.