Medicaid

This presentation, delivered by Charles Milligan to the Medicaid and CHIP Payment and Access Commission (MACPAC) in Washington, D.C., addressed the issue of coordinating long-term care for persons eligible for both Medicare and Medicaid (dual eligibles). Milligan discussed Hilltop's research on Medicare/Medicaid cross-payer effects that found that Medicare and Medicaid financing do not align to promote home and community-based services.

Most Medicaid beneficiaries are enrolled in some form of managed care. States are expected to increase their reliance on managed care to deliver services in their Medicaid programs. This 50-state survey provides a comprehensive look at state Medicaid managed care programs, documenting their diversity, examining how states monitor access and quality, and exploring emerging efforts to improve care, including managed long-term care and initiatives targeted toward dual eligibles.

This document is the latest in a series of reports on Medicaid long-term services and supports (LTSS) spending. This year’s report contains newly available data and changes in the services that are included within LTSS. The report explains the changes, summarizes the data, and describes national trends.

The latest brief describes Medicaid expenditures in 2009, showing that 45% of its total long-term care dollars nationally were spent on home- and community-based services. The findings in this analysis are based on the CMS Form 64 data published by Thomson Reuters, detailing each state’s Medicaid expenditures.

The latest in a series provides background on the landscape of home- and community-based long-term care services funded by Medi-Cal, California's Medicaid program. In-Home Supportive Services (IHSS) is the largest personal care program in the nation.

This letter provides guidance on state flexibility to make changes to their home and community-based services (HCBS) programs while complying with the maintenance of effort (MOE) provision of the Affordable Care Act. Letter recommends that States contact CMS for technical assistance if they are interested in pursuing any changes to their long-term care policies. The accompanying Q&As provide guidance on the MOE provisions in the Patient Protection and Affordable Care Act.

This issue brief is the first in a series of four papers designed to highlight pressing issues facing dual eligibles and provide recommendations to the Medicare-Medicaid Coordination Office, state Medicaid agencies and other interested policymakers and stakeholders on how to address them. This first paper provides recommendations for consumer protections in delivery system models that integrate Medicare and Medicaid.

How does the state of Virginia measure how financial incentives affect disabled workers' decision to work? To learn more, read this report which features a model used to predict behavior of individuals, budget costs, and related savings of the Virginia Medicaid Works program, along with the well-being of affected individuals. This frame-work will also be used to predict how proposed changes in the Medicaid Works program would affect behavior.

How is the state of Virginia working to better understand its Medicaid program's efficacy? This report aims to develop a framework to understand the incentive effects of the Virginia Medicaid Works program that provides disabled Medicaid recipients the option to earn higher income while ensuring continued Medicaid coverage. By decoupling labor market decisions from Medicaid receipt, the primary objective of the Works program is to increase the employment and earnings of disabled recipients.

The Utah Medicaid Work Incentive (MWI) Program began in 2001 as a way to encourage low income people with disabilities to work without fear of losing needed health care services. The program allows people with disabilities to earn above the poverty level to have access to Medicaid as long as their income remains low. The purpose of this study was to assess the impact of MWI policy on recipients’ earnings, Medicaid expenditures, and use of other public benefits.