Medicaid

The coordination of Medicare and Medicaid benefits and services for dually eligible enrollees has been a longstanding policy challenge. Several provisions of the Affordable Care Act (ACA) attempt to address this lack of coordination. This paper reviews the major changes under the ACA directed at care coordination for the dually eligible population and then concludes with a discussion of the continuing legislative and legal challenges in integrating care for the dually eligible.

A statistical model was developed to assess the effect of rebalancing on overall spending for long-term services and supports (LTSS). The model indicates that spending is affected by the way rebalancing is implemented: Gradual rebalancing can reduce spending by about 15 percent over ten years. Because many states continue to experience budget crises, policy makers must think carefully before altering spending patterns for LTSS and adopt strategies to successfully reduce overall spending.

Supported by the Pew Home Visiting Campaign, NASHP conducted a scan of state policies and practices and convened an expert panel to identify mechanisms for supporting home visiting services through Medicaid. This report explores various Medicaid financing mechanisms states could use to support home visiting services and considerations for states exploring these financing options.

Centers for Medicare and Medicaid Services (CMS) has provided funding and technical assistance to states to develop state plans' to coordinate care for dual eligibles, persons eligible for both Medicare and Medicaid. This chart shows the status of those states selected for the Dual Demonstration grants, the model chosen, and target implementation. It also includes links to each state's plan.

An Accountable Care Organization (ACO) is a provider-run organization in which the participating providers are collectively responsible for the care of an enrolled population. This brief examines the existing Medicaid payment and care delivery landscape in states undertaking Medicaid ACO initiatives to gain insights into how ACOs fit into states’ Medicaid programs, and to identify important differences between Medicaid ACOs and ACOs in Medicare and the private insurance market.

This brief explains how Medicare beneficiaries become eligible for Medicaid, provides national & state-by-state data on enrollment, & examines national & state-specific data on Medicaid spending for dual-eligible beneficiaries by service & eligibility group. The Foundation also has a collection of resources on dual-eligible beneficiaries, including basic facts & data, and analysis & explanation of specific issues, which include provisions of health reform affecting dual-eligible beneficiaries.

In 2014, most homeless people will become Medicaid-eligible under the Affordable Care Act. Many homeless people have physical and behavioral health conditions for which they seek care through frequent use of emergency rooms and inpatient hospitalization, at considerable cost in public resources. Medicaid reimbursement is an important source of funding for services that help homeless people succeed in housing and stop such inappropriate use of crisis health services.

This portion of the Center for PAS website presents various data and resources related to Personal Assistance Services by state. Recent updates include two sets of information concerning Medicaid home-and community-based services (HCBS). Users can select a state or select a specific topic such as state statistics, program data, and other PAS projects.

The goals of the survey, which was sent to direct-care workers serving participants using the MI Choice SD option, were to: collect baseline demographic information on workers in the SD option; understand the motivations, job satisfaction, and training needs of workers providing services and supports to self-directed participants; and,identify strategies to strengthen and support the recruitment and retention of workers in self-directed programs.

This report describes the process of assembling and integrating Medicaid and Medicare data to study recipients of HCBS in California. Subsequent reports will describe disability levels and service use of HCBS users in Medi-Cal only and dual eligibles between 2005 and 2008.