Data

Learn about the status of the public LTC delivery system, and opportunities and obstacles for LTSS reform and rebalancing. The study surveys states’ current HCBS expenditures and utilization, analyzes factors underpinning Medicaid’s institutional bias, looks at federal and state initiatives to improve the ratio between institutional and community-based care, and points to statutory and regulatory “fixes” that could enhance the states’ ability to improve their LTC delivery systems.

To inform long-term care reform efforts, a web-based survey of over 1,000 LTC specialists nationwide was conducted. Findings included the need for LTC to be rebalanced toward HCBS settings, though few supported doing so by limiting nursing home bed supply. Although virtually all felt that the federal government was doing a poor job regulating LTC providers, most believed that the approaches used to oversee nursing homes should also be applied to assisted living.

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.

Statistics for how many people on the Social Security disability rolls return to work published by the SSA each year are based on the behavior of beneficiaries over a short period. Longer-term statistics offer “good news” in that, compared to the short-term statistics, they show more beneficiaries leaving the rolls after finding work. They also show that some beneficiaries who return to work but don’t leave the rolls could become more self sufficient if better work incentives were in place.

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.

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.

How can ADRCs increase their outreach and strengthen their relationship with diverse populations and community-based organizational partners? This brief provides an overview of cultural competence including its definition and how it can be best implemented. Also included are key demographics, barriers to culturally competent service provision, organizational assessment tools, practices and standards, and a list of cultural competence resources that may be useful for ADRC staff.

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.

While long term care costs continue to rise nationally, the cost for in-home care is rising at a much slower pace. Complete national and state cost of care data can be found in the full report. Other reports include an Executive Summary of key findings, detailed methodology information and listings of counties involved in the survey. Also find an interactive map detailing costs within each state.

What are the long term effects of MIG programs on wages? The state of Virginia evaluated the long-term impact of Vocational Rehabilitative (VR) services on employment, earnings and services provisions. Preliminary findings indicate that VR services have a substantial positive impact on future employment probabilities but very little impact on wages. A sample of this data-filled report is attached, and could be helpful to other states conducting similar studies.