Policy alerts, briefs, letters & papers

The Kaiser Family Foundation released an issue brief that analyzes the cost of Medicare Part D drug plans, specifically out-of-pocket costs for Medicare beneficiaries. A major finding from the brief showed that Medicare Part D enrollees may pay thousands of dollars of out-of-pocket costs if they require a specialty drug, even after exceeding the catastrophic coverage threshold. This study's findings emphasize how important it is for beneficiaries to diligently shop for new plans each year.

The LEAD Center published a policy brief that examines the impact of employment programs on health care costs for working-age people with disabilities. People with disabilities are responsible for a disproportionate amount of healthcare spending each year, mainly through Medicare and Medicaid. Employment of people with disabilities shows a "protective impact" on health, which would ultimately help to lower public spending on health care for this population.

The Kaiser Family Foundation published an issue brief of the role of Medicaid for People living with dementia. Individuals with dementia generally require a multitude of medical and behavioral health services. Medicare covers some services for this population but there are gaps where Medicaid may need to fill in for payment of long term services and supports (LTSS) for low-income people. This brief includes a fact sheet for explain the role of Medicaid for people with dementia.

The Integrated Care Resource Center released a brief that offers tips for engaging providers in integrated care programs for Medicare-Medicaid enrollees. Integrated care programs are successful when a broad spectrum of providers are engaged in the process. This brief provides states with tips on how to engage physicians, hospitals, nursing facilities, and community-based service providers that serve Medicare and Medicaid enrollees.

The United States Departments of Health and Human Services and Education released a policy statement on September 14, 2015, that declares that all children with disabilities should be allowed access to "inclusive high-quality" early childhood programs, "where they are provided with individualized and appropriate support in meeting high expectations." Presently, children with disabilities and their families face difficulties in accessing these programs that are available for their peers.

The Center for Health Care Strategies released a brief, funded by the Commonwealth Fund, that examined member engagement approaches used by participating health plans in Promoting Integrated Direct Care for Eligibles (PRIDE). The brief highlights promising strategies for providing Medicare-Medicaid enrollees with complex medical, behavioral health, and social service needs. There is a specific emphasis on the approaches to building trusting relationships with members.

For Social Security beneficiaries and Supplemental Security Income recipients who are not capable of managing their own benefit payments, the Social Security Administration (SSA) pays benefits to a representative payee. The authors estimate that the demand for representative payees will increase from 2.94 million beneficiaries in 2013 to 3.27 million by 2025 and to 3.56 million by 2035.

Research from the AARP Public Policy Institute/Urban Institute shows the uninsured rates for 50- to 64- year-olds dropped 31% between December 2013 and December 2014. In states that expanded their Medicaid programs, the drops were greater. The analysis uses preliminary data from the second open enrollment period of the Affordable Care Act.

This report seeks to provide empirical evidence on the relationship between the primary impairments of Social Security disability program beneficiaries and the employment and earnings experiences of those beneficiaries. The authors' findings can inform new initiatives designed to help beneficiaries return to work or successfully transition into the adult workforce.

Person-centered planning encompasses the idea that the individual is at the heart of all decisions about services, supports, and care. This report analyzes how well states are implementing a 2014 rule that creates the right to person-centered care planning for Medicaid consumers of Long-Term Services and Supports. The report is a tool for health care providers, plan administrators, and advocates to help them understand the scope of the rules and be able to identify provision shortfalls.