Medicaid

This study of Consumer Directed Care, Florida's Cash & Counseling Demonstration program for children, examines the ways in which consumer direction affects the cost of Medicaid personal care services, as well as the cost and use of other Medicaid services. Outcome measures were drawn from Medicaid claims data for 1,002 children for the first two years post-enrollment.

This brief reviews the history and current status of federal special needs plans (SNPs) authority, with particular attention to provisions of interest to state Medicaid programs that have or are considering entering into contracts with SNPs to integrate or coordinate Medicaid long-term care services with Medicare primary, acute and prescription drug services for dually eligible beneficiaries. Key future changes to the program and a legislative history are outlined.

This series of chart books summarizes demographic, service utilization, and expenditure data for state fiscal years 2001 through 2008 on three Maryland Medicaid waiver programs — Older Adults, Living at Home, and Autism, and on nursing facility utilization among Maryland Medicaid recipients. These books are now available to the public online to monitor trends in these programs.

Arkansas’ Cash & Counseling Demonstration program, IndependentChoices, was studied to examine the ways in which consumer-direction affects the cost of Medicaid personal care services, as well as the cost and use of other Medicaid and Medicare services. The study also examines the affect the program had on service utilization.

This study of Florida's Cash & Counseling demonstration program, Consumer Directed Care (CDC), compares children's use of services and quality of care under traditional versus consumer-directed approaches to Medicaid HCBS.

This article discusses the benefits and opportunities presented as a result of the Center for Medicare and Medicaid Services (CMS) publishing the final Medicaid rule that permits Medicaid recipients to self–direct their own health care and supportive services. The rule is known as Self–Directed Personal Assistance Services Program State Plan Option (Cash & Counseling).

This presentation was given for the Administration on Aging Nursing Home Diversion and Modernization grantees. The presentation compares Medicaid requirements for a Cash & Counseling type option to non-Medicaid practices.

This brief describes the evolution of beneficiary-managed home and community-based services since the original demonstration and provides an overview of state activity as of January 2006. The Deficit Reduction Act of 2005 gives states the option to use this model for an expanded range of home and community based services in their state Medicaid plans without having to obtain a waiver.

This report and tables present Medicaid 1915(c) Home and Community-Based Services (HCBS) Waiver expenditures data from Federal Fiscal Years 2003 through 2008. Each HCBS waiver is classified by population served in order to show the distribution of expenditures across long-term care populations. This report includes new target population categories to identify waivers that target particular developmental disabilities such as intellectual disabilities and autism spectrum disorders.

The proportion of long-term care spending that goes to institutional care has been dropping over time, from 81 percent in 1995 to 63 percent in 2005. However, there remains significant concern that many people who would prefer to receive care in the community are unable to do so because of what has been termed the ‘institutional bias’ of Medicaid. This report discusses the issues surrounding efforts underway to shift the balance toward HCBS in the state of Pennsylvania.