Reports

This issue brief explores the continuing evolution of the Medicaid program on several fronts. It discusses the benefits and cost-sharing flexibility that is included in the Deficit Reduction Act and examines the implications for states, beneficiaries, and providers. The paper also explores recent trends in section 1115 waiver development and considers the use of waivers as a vehicle for restructuring Medicaid financing systems and for testing completely new approaches to health care delivery.

Coordinated care organizations (CCO) are an emerging person-centered health delivery system for community-based Medicaid adults with disabilities or complex chronic disease. This report develops recommendations on how states can support CCOs. The recommendations are drawn from visits to seven pilot programs in NC, MN, MA, NY, VT, WI. This report reviews the challenges the CCOs encounter in measuring quality and offers a comprehensive approach for developing an actionable measurement set.

The Hennepin County Human Services and Public Health Department outlines the accomplishments made to date after their one-year initiative. They also offer their future plans for implementation.

This brief provides background information on characteristics of the MR/DD population and describes the major information and service needs of the MR/DD population and the existing supports and services system. The brief also addresses implications for grantees serving this population and provides additional resources to facilitate ADRC planning and operations.

The second in the series, this paper identifies the features of high-quality integrated community services and the systems that support them and serves as the foundation work for additional exploration. The paper will undergo continuing development in discussions with representatives of projects and consumer leaders, will augment assessment of existing systems and planning of new or improved systems, and ideally become an even more useful tool for those involved in systems transformation.

First of Three Papers on Unlocking the Code of Effective Systems Change - This paper attempts to create an overall framework for the discussion of systems change and to give a summary of the concepts. Several specific recommendations from other successful programs and the recommendations and guidance of the colloquium participants, can be applied now by any grantee, state, or program to enhance prospects of achieving enduring change in home- and community-based services.

How are ADRCs and other non-profits using mobile technology? For staff who spend time traveling to clients homes and providing services in a non-office setting, portable information is a must. This issue brief provides some basic information about the most common forms of mobile technology and some issues to consider before adopting portable equipment as a service delivery tool. Also included are the ways information is accessed, collecting client data plus the approaches used by other states.

This report draws on interviews with Medicaid care planners for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

This report draws on interviews with state Medicaid program officials for insight into the issues that arise in establishing programs to move individuals with significant long-term care needs from institutional to community settings. The five states that participated in this study—Florida, Louisiana, New Jersey, Ohio and Washington—each received federal grants for nursing home transition activities and had varied experiences.

Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act tightened Medicaid eligibility rules. About 43 percent of all nursing home residents eventually become Medicaid eligible. Over the six-year period examined, the authors estimate that, when applying the DRA asset transfer rules, federal savings to Medicaid could amount to $1.87 billion.