Reports

MACPAC’s 2018 Report to Congress on Medicaid and CHIP addresses managed care, telehealth, and disproportionate share hospital (DSH) payment. The report presents recommendations and analyses backed up by analyses of administrative data and reviews of federal and state policies in each of these areas.

This report describes the current state of the direct support professionals (DSP) workforce as a crisis. DSPs promote participation in the U.S. economy, and yet the average DSP wage is $10.72, most work two or three jobs, and the average annual DSP turnover rate is 45%. This report explores how these issues affect individuals, families, and human services systems; the factors that contribute to these issues; and promising practices to strengthen the direct support workforce.

The Institute on Disability has released the latest Annual Disability Statistics Compendium and Report. The Compendium includes many tables of data, including state and national values and trends over time. The Annual Report highlights state and trend data, and complements the detailed tables available in the Compendium & Supplement. The Annual Report includes maps to highlight the variability in disability rates by state, and each map is related to a specific table from the Compendium.

This annual report from Cornell University provides a summary of the most recent demographic and economic statistics on the non-institutionalized population with disabilities. The report includes information about the population size and disability prevalence for various demographic subpopulations. Statistics related to employment, earnings, household income, veterans' service-connected disability and health insurance are also included.

This report examines state and federal oversight of assisted living services in Medicaid. Individuals receiving long-term care services from Medicaid in community residential settings is expected to grow. This report describes state spending on and coverage of these services; describes how state Medicaid agencies oversee the health and welfare of beneficiaries in these settings; and examines the extent that CMS oversees state Medicaid agency monitoring of assisted living services.

This report from the Kaiser Family Foundation addresses Medicare beneficiaries’ out-of-pocket health care spending. This report highlights the rising medical costs for low-income older adults. It is estimated that by 2030, Medicare beneficiaries will be spending half of their Social Security benefit on out-of-pocket Medicare expenses.

This report outlines concrete steps to protect vulnerable Social Security beneficiaries and recipients. The report includes recommendations for Congress, the Office of Management and Budget and SSA to strengthen the current administrative process, create better monitoring and explore comprehensive, government-wide coordination and cross-agency reform of rep-payee processes.

The Administration for Community Living (ACL), joined the Department of Health and Human Services (HHS) Office of Inspector General (OIG) and the HHS Office of Civil Rights to produce a report on ensuring beneficiary health and safety in group homes through state implementation of comprehensive compliance oversight. This report serves as a resource for states to use as a part of efforts to ensure that all group homes are safe and healthy places for people with disabilities.

The Government Accountability Office (GAO) examined states’ needs assessment processes for provision of long-term services and supports. GAO studied six states that differed in the following ways: assessment tools in use, participation in federal initiatives, HCBS delivery systems, and geographic location. GAO also reviewed federal requirements and documents and interviewed CMS officials and stakeholders.

This report discusses how state employee health plans are a vehicle that states can use for improving their health care system and moving the commercial market forward on value-based reforms. Currently, in 18 states, state employee plans cover over 10% of the commercial market. State employee health plans have seen success with reference pricing, limited networks, tiering, bundles, and accountable care models.