Formative Evaluation

On June 12th, the Centers for Medicare & Medicaid Services (CMS) released an Addendum to the 2024-2025 Medicaid Managed Care Rate Development Guide. The guide also includes the provisions of the final rule that will take effect on July 9th, 2024. The 2024-2025 Medicaid Managed Care Rate Development Guide is a resource for states to use when setting capitation rates with managed care plans for care beneficiaries to receive through Medicaid managed care programs. The guide provides details around information that must be included in the states’ actuarial rate certifications for CMS to review and approve for rating periods between July 1, 2024, and June 30, 2025.

AARP has released an update from their Public Policy Livable Communities division, which explains that communities need to encourage more accessible homes for older adults and their families by requiring that single family homes meet visitability requirements with features such as having an entrance without steps, kitchen counters set at multiple heights, and half-bathrooms at the ground level.

The fifth in a series of annual reports from the national evaluation of the MFP rebalancing demonstration, the report presents three sets of analyses that show the overall progress and effects of the MFP demonstration: progress made by grantees on their statutory transition and expenditure goals; the extent to which states are rebalancing their LTSS systems; and 3) changes in expenditures patterns and utilization of select services following an individual's transition from institutional to HCBS.

This report brings together available evidence on the effect of PACE on several key outcomes: Medicare and Medicaid costs, hospital and nursing home utilization, quality of care, satisfaction and quality of life, and mortality. The authors summarize findings from past studies and assess their methodological approach. They improve on these earlier evaluations by conducting a more detailed review of the studies, as well as a more rigorous assessment of the quality of evidence presented in each.

This study evaluates the outcomes of the disability applications submitted to the Social Security Administration (SSA) through the Benefits Entitlement Services Team (B.E.S.T) Demonstration Project. B.E.S.T was a collaborative effort to locate homeless adults and assist them in applying for Supplemental Security Income (SSI) payments and/or Disability Insurance (DI). The findings show that B.E.S.T contributed to increased access to disability benefits for applicants.

Review the progress by the 42 MFP grantee states (including the District of Columbia) that are actively transitioning MFP participants. MFP grants support state efforts to help individuals living in institutions move to home and community-based settings if that is where they wish to receive LTSS. During the second half of 2013, states transitioned 5,485 new enrollees, bringing the total number of people that had ever transitioned to the community through MFP to 40,693 at the close of 2013.