Medicaid

Via IHSS Plus, participants are able to receive certain expanded in-home services as part of Medi-Cal. Before, payments for these services were not matched by a federal contribution and were administered through a separate program. The analysis looks at implementation and service use in 2005, compares recipients’ outcomes and institutionalization rates to those in the original IHSS program, and complements the State’s evaluation and other research on paying family caregivers.

New York spends more than most states on Medicaid and long-term care. To understand why this is, the following traits are evaluated: demographics of residents over 65; poverty level; long-term care spending, budgets, and services; and quality of nursing home care. The findings identify a number of demographic and program factors likely contributing to the high rate of spending.

Money Follows the Person (MFP) programs only target 0.9% of the people that could be eligible for transitioning out of institutions each year. However, there is a potential to increase rates to 15-40% annually depending on quality of program implementation, who is targeted, and how successful states are in overcoming barriers to transitioning high-needs people. The report looks at grantee states’ potential for accomplishing this rate increase.

For many years, Section 1115 waivers have been used in the Medicaid program and the Children’s Health Insurance Program, to provide states an avenue to test and implement coverage approaches that do not meet federal program rules. While these waivers have facilitated important program evolutions over time, some have also raised issues. This brief reviews the experience of Section 1115 Medicaid and CHIP waivers and discusses issues for the Obama administration to consider for the future.

Medicaid covers health and long-term care services for many millions of low-income Americans. Conversations were already underway at this event concerning the role of Medicaid as a vehicle for economic stimulus, and about health coverage expansion proposals, with particular discussion around the challenges facing states implementing the program in the recent economic downturn.

The authors present evidence in support of states investing in HCBS and nursing home diversion as strategies to deal with declining revenue. They review research reports illustrating how the balance of spending on institutional versus HCBS spending affects future long-term care costs. Using these data and case studies of Washington and Vermont programs, they conclude that HCBS is indeed cost-effective.

The question posed in the title is answered by analyzing state spending data from 1995-2005. The report shows that, for two distinct populations receiving long-term care services, spending growth was greater for states offering limited noninstitutional services than for states with large, well-established noninstitutional programs. Expansion of HCBS appears to entail a short-term increase in spending, followed by a reduction in institutional spending and long-term cost savings.

This fact sheet examines the assistance for Medicaid programs and key health provisions in the ARRA that President Obama signed into law on February 17, 2009. Subjects covered include the temporary increase in federal matching money for state Medicaid programs, subsidies for COBRA health coverage for laid off workers and funding for health information technology. It includes a breakdown of additional federal allocations to states for Medicaid costs under the act.

An interactive map displays how many 1915(c) waivers each state has. Clicking on a state’s name displays number of participant and expenditures by waiver type as compared to nationwide numbers. Participant and expenditure data are also available for personal care, home health, and individualized budget services. Clicking “Compare” in any data area displays a table illustrating selected data for all states. Information is taken from CMS form 372 and is downloadable.

Medicaid expenditures are often presented as a percentage of state or Federal spending. Here, they are illustrated in terms of market shares for 30 markets defined by provider category of service. In 21 markets, Medicaid plays a small role, but in the other 9, such as long-term care and mental health, Medicaid is the dominant payer. Some of the other markets researched include adult day, waiver, case management and home health services.