Medicaid

The report presents findings from a 50-state survey examining how well the needs of family caregivers are assessed when states evaluate the needs of older people & adults with disabilities who qualify for HCBS programs under Medicaid. It is the first detailed analysis of family caregiver assessment tools and processes in use by the states in Medicaid waiver programs. The report also highlights “promising practices” in family caregiver assessment in 3 states, and offers policy recommendations.

This guidance document is intended to provide guidance to states on how to apply the revised protocols for External Quality Review (EQR) of Medicaid managed care organizations, released in 2012, to managed long term services and supports (MLTSS) programs. Although the protocols already apply to MLTSS generally, this document offers specific suggestions to make their application to long term services and supports (LTSS) clearer and provides suggestions, examples and illustrations.

The annual Medicaid Long Term Services and Supports expenditure report includes Medicaid expenditures for all LTSS, including institutional and non-institutional settings, by service category and state. The data come primarily from CMS-64 reports.

New research from AARP and ADvancing States finds that two-thirds of states either have or will launch new initiatives to better coordinate care for people who are dually eligible for Medicare and Medicaid services over the next two years. To contain the growth of costs and improve care, many are moving to risk-based managed long-term services and supports models. This research finds that a number of states are exploring approaches to dual services integration outside of the CMS models.

This presentation at the 2012 Aging in America Conference provides an overview of the basics of Medicaid and traces the major trends in reform, including the Olmstead decision and subsequent move toward home and community-based services; the promulgation of Medicaid Managed Long-Term Services and Supports (LTSS); and a focus on “dual eligibles”.

A February 2012 online survey consisting of 30 questions was sent to all states and focused on three topics: consumer-directed personal care services; assessments and care plan changes; and case management. The survey results provide information about respondent states’ practices regarding Medicaid funded LTSS. Consumer-directed care was found to be provided majorly through waivers; most assessments contracted out; and case management paid for as a service rather than administrative cost.

This survey was sent to all states and consisted of three questions regarding the enrollment of Medicaid providers of home and community-based services. Of the 23 states that responded, the results highlight different enrollment procedures and opportunities for HCBS providers and varying agency oversight. The results show that Medicaid HCBS provider enrollment oversight varies by state, the majority reporting that the Medicaid agency, as opposed to the state aging agency, manages the process.

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).

State aging and disability agencies have operated within a tumultuous environment for the past several years. It has become increasingly more difficult to reconcile the needs of older adults and people with disabilities with the resources available to address those needs. Five themes are identified from the 2012 state of aging and disabilities surveys, which include the acceleration of Medicaid managed long term services and supports and continuing loss of historical knowledge around the nation.

This letter provides State Directors of State Units on Aging (SUAs) with information regarding the CMS decision to reduce Medicare skilled nursing facility (SNF) payments by 11.1% for FY 2012 (a reduction of $3.87 billion). The decision is supposed to create more efficiency in the Prospective Payment System (PPS). The memo describes the implications of such a decision coupled with frozen or reduced Medicaid payments to SNFs and Long Term Care Hospitals (LTCHs).