Medicaid

Fourth and final in a series that explores the cross-payer effects of providing Medicaid long-term supports and services on Medicare acute care resource use, this report provides a summary of the initial work of a study, described more fully in the first three reports, with an emphasis on lessons that state Medicaid administrators should consider as they move toward more formal programs of integrated care for persons dually eligible for Medicare and Medicaid.

Many obstacles impede states from rebalancing their long-term supports and services (LTSS) programs toward greater emphasis on HCBS alternatives. This brief outlines policy recommendations for reforming the Medicaid-funded LTSS system to support more cost-effective and consumer-oriented long-term care options. The authors discuss the current LTC environment, barriers and promising solutions to rebalancing LTSS, and policy recommendations for improving the Medicaid LTSS system.

This letter was issued to provide information on new tools for community integration and to remind States of existing tools that remain strong resources in their efforts to support community living. Various technical assistance resources are listed, including a new guide for enhancing the availability of HCBS within managed care delivery systems. Progress around the HUD partnership, HCBS waiver and state plan options, grant programs, ADRCs and discharge planning are discussed as well.

Looking for job skills training materials? The state of Nevada created the attached work program samples. They include a class outline booklet, sample completion certificate, high school letter, job skills brochure, job skills flyer, programmatic report, resume template and short biography template. These templates could be useful to other MIG states interested in this approach to job skills training.

Explore innovative initiatives from across the nation offering alternatives for reforming the delivery of Medicaid-funded long-term care. This report includes both innovations that have been implemented as well as promising practices. Innovations included cover provider-focused initiatives, new directions for managed long-term care, administrative and financing solutions; and emerging telehealth technologies.

How are MIG states working to educate people with disabilities who want to work about incentives that won’t disqualify them for Medicaid health care coverage? The state of North Dakota created this advertisement to summarize program benefits and qualifications, and list other contacts and resources for information and help. It is an approach that could be useful to other states looking to dispel popular misconceptions.

How do dually eligible beneficiaries affect state MIG grant programs? Rhode Island and the University of RI, College of Pharmacy produced a chart book which highlights demographics, healthcare services, expenditures and the variation in cost by settings of care for seniors and people with disabilities who were enrolled in both Medicare and Medicaid between 1995-2005. Objectives and findings are included. An sample of this book is attached and could be helpful to other MIG grantees.

The Sherlock Plan is the name of Rhode Island’s MIG program. It allows qualified working people with disabilities to earn more income without the risk of losing vital health care coverage. To inform consumers about the program, they have provided a plan overview, fact sheets in Spanish and English, and more information on their "Rhodes to Independence" website. Samples of these documents and a link to the site are available.

An expert explores patterns in services and spending under long-term care programs and examines the rise in HCBS, the existence of waivers from federal and state coverage requirements, and the changing populations who use long-term care services. He concludes with a discussion on the need to reduce the fragmentation and lack of coordination in LTC services by removing the divide between Medicare and Medicaid programs. Listen to the recorded webinar and find Mr. Ng’s published paper.

Turning the many acronyms that make up the landscape of MIG programs into something youth with disabilities and their families can understand and utilize is essential in effecting successful transitions from school to employment. Utah created the attached presentation for a workshop designed to break down these acronyms into meaningful opportunities. This playful approach is something that other MIG grantees could find useful.