Comparison Table, Matrix or Chart

Despite decades of increases in program participation and spending, the disability support infrastructure in the United States and the economic independence of people with disabilities have eroded. Rather than tighten eligibility or reduce program benefits, this issue brief proposes gradual programmatic reforms and evidence-based structural changes to improve the economic status of Americans with disabilities.

Many states are undergoing long-term services & supports (LTSS) transformations. The lagging economy & increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs & another 11 with plans for implementation. Many states used the economic downturn as an opportunity to balance services from institutional to non-institutional settings.

Despite continued fiscal pressures on states, eligibility policies remained stable in nearly all state Medicaid and Children's Health Insurance Programs during 2011. Moreover, many states used technology to increase program efficiency and streamline enrollment. The "maintenance of eligibility" requirement in the Affordable Care Act (ACA) played a key role in preserving coverage levels. Without it, more states likely would have limited eligibility or tightened enrollment procedures.

Enrollment in MFP continued to grow steadily with 15,818 cumulative transitions to the community as of June 30, 2011, a 33 percent increase from the end of 2010. The states reported 3,722 new transitions during the six-month period from January to June 2011, 9 percent more than in the previous six-month period. The report provides an overview of state MFP grantee progress on key performance indicators and challenges states reported when implementing their transition programs.

Examine new state-by-state estimates of public and private health spending from the Centers for Medicare and Medicaid Services (CMS), published in the online journal, Medicare and Medicaid Research Review. Also available, a webcast with an expert panel offering perspectives on the trends within and across states, as well as the outlook for policy efforts to control costs, including provisions of the Affordable Care Act and various state initiatives.

This survey contains daily private-pay rates for private & semi-private rooms in licensed nursing homes, monthly base rates for assisted living communities, hourly rates for home health aides from licensed agencies & agency-provided homemaker companion services, & daily rates for adult day services across the US. Costs for this survey were calculated for each service provider in an area & were aggregated across all providers to compute a statewide average cost.

Medicaid officials in every state are enacting a variety of cost cutting measures as states’ spending is projected to increase 28.7% in FY2012 to make up for the loss of federal stimulus money. The survey finds cost containment actions ranging from restrictions on payments to providers & benefits, to new copayments for beneficiaries & additional efforts to contain the costs of prescription drugs. States are also trying to make their programs more efficient through a number of procedures.

Despite more than $428 billion in spending in FY2008 to assist working-age people with disabilities, services provided are often fragmented, confusing, & less effective than they could be. This brief explains how the government serves a caretaker role. Authors point out that this model runs contrary to the goal of maximizing self-sufficiency embraced by the Americans with Disabilities Act & fails to direct funds to help those with disabilities join, remain in, or return to the workforce.

This Chart Book reports on nursing facility services provided to Maryland Medicaid beneficiaries aged 19 years and older. It summarizes demographic, service utilization, acuity, expenditure, and length of stay data for fiscal years 2006 through 2009. This Chart Book was prepared for the Maryland Department of Health and Mental Hygiene and is intended to monitor trends. Hilltop updates the chart book annually.

With the growing role of home and community-based services in Medicaid long-term services & supports, an understanding of the different characteristics of the population transitioning from institutional care to HCBS, the trends occurring in LTSS & the effect of the different programs is needed. Hilltop developed a series of metrics to present to the Maryland Money Follows the Person Stakeholder Advisory Group now in the form of chart books. These metrics can be tailored for any state.