Medicaid

Answering the question posed in the title is one key to evaluating Medicaid Buy-In (MBI) programs. This issue brief, the fifth in a series on workers with disabilities, compares demographics, health status, and expenditures between these groups. Significant areas of difference that were identified are race, gender, diagnoses, and expenditures.

A recent trend in health care has been the increasing integration of behavioral health services into primary care settings. This paper discusses the benefits of such integration and the role of safety net primary care providers as behavioral health providers within the Medicaid program. The authors focus on organizational structure and reimbursement models in analyzing how four state programs achieve this integration.

This paper examines the use of research, demonstration, and program waivers as vehicles for innovation in the delivery and payment of health care and long-term care. It summarizes the context of the creation of the programs and reviews their legal underpinnings. It also analyzes the dynamics between state and federal authorities. Finally, the paper examines the impact of the Deficit Reduction Act of 2005 on the need for or desirability of waivers.

MAPP is the Wisconsin Medicaid Buy-In program, allowing qualified workers with disabilities to purchase Medicaid healthcare coverage. Find here several reports outlining enrollment and expenditure data, policies and activities. Also available is a report that evaluates the effectiveness of WI’s return-to-work programs.

This memorandum and tables present data on Medicaid 1915(c) Home and Community-Based Services (HCBS) waiver expenditures from Federal Fiscal Years 2002 through 2007. Each HCBS waiver is classified by population served in order to show the distribution of HCBS waiver expenditures across long term care populations.

This memorandum presents data on Medicaid long-term care expenditures in Federal Fiscal Year 2007 (Oct 2006-Sept 2007). Table 1 presents national data on Medicaid expenditures for Long-Term Care from 1995-2007. Other tables present state-by-state data for Nursing Homes, ICF/MR, Personal Care, HCBS Waivers, Home Health, Home Care, 1115 Waivers focused on HCBS, and other Medicaid services.

This document sums up the funding, goals, and objectives of the MIG programs for people with developmental disabilities in Washington. It includes contact information for partner organizations, benefits specialists in each county and statewide technical assistance providers.

Find here examples of communications used to answer questions about eligibility and the application process for waiver programs. The first handout summarizes the three levels of financial eligibility and strategies for helping an individual maintain benefits. The second resource, a training presentation, provides this information in more detail and uses an anecdotal character to walk through the requirements. Finally, the chart illustrates basic eligibility requirements in a simple chart.

Here is an example of a tool used to educate service providers and consumers about how SSI recipients can keep Medicaid through 1619(b) even if the earn too much to continue receiving an SSI check. The presentation covers eligibility requirements and the application process. In addition, it points people towards resources for further help and information if needed.

The Center for Workers with Disabilities prepared this report for the Virginia MIG advisory committee. It contains an analysis of the ways states provide personal assistance services (PAS) through a personal care Medicaid State Plan Option (SPO) to persons in Buy-In programs. It looks at specific legislation, State Plans and amendments, administrative rules, and implementation manuals. It ends with recommendations from an analysis conducted for Iowa on whether to implement this option there.