Reports

The OIG report examines state standards and requirements for network adequacy and access to care. The report was based on surveys and interviews of state officials, CMS employees, and External Quality Review Organizations. In the report, OIG notes that state standards on access to care vary widely, and that state oversight of health plans also varies. Based on its findings, OIG offers recommendations to CMS in the report.

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 paper identifies the concerns and considerations in transitioning traditional LTSS providers from fee-to-service models to a managed care program.The findings of the study are based on qualitative interviews conducted with a variety of stakeholders, including state Medicaid program officials, representatives from managed care companies, LTSS providers, LTSS provider associations, and private consultants.

This white paper provides an inventory of all current MLTSS programs and a projection of future programs as of July 2012. The report includes state-by-state results and synthesizes findings across states, reporting national enrollment, characteristics of contractors and multiple program features.

This State Long-Term Services and Supports (LTSS) Scorecard is a multidimensional approach to measure state-level performance of LTSS systems that assist older people, adults with disabilities, and their family caregivers. This second edition of the State LTSS Scorecard measures LTSS system performance across five key dimensions: affordability and access; choice of setting and provider; quality of life and quality of care; support for family caregivers; and effective transitions.

Medicaid LTSS is not a system that was purposefully built, but rather one that evolved over time out of legacy programs that were designed to meet the needs of different populations, differing state approaches to policy, court decisions, client advocacy, and changing ideas about where and how LTSS should be provided. MACPAC’s future work on Medicaid LTSS will focus on building a better understanding and moving policy in the direction of a more efficient and effective system of LTSS.

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.

The Money Follows the Person (MFP) demonstration grant program helps long-term residents of institutions move back to the community. This report aims to answer several questions about the expenditures (medical care and long-term services and supports [LTSS] expenditures) of people who transition from institutional care to community-based LTSS.

This report summarizes audited Healthcare Effectiveness Data and Information Set (HEDIS) results for calendar year 2013. Data come from a record number of health plans -- 814 HMOs and 353 PPOs, representing more than 171 million people, or 54 percent of the U.S. population.

This report fulfills NCD’s statutory mandate to annually report and make recommendations concerning the state of disability policy in the United States. Specifically, the 2014 Progress Report focuses on seven key areas: the Convention on the Rights of People with Disabilities (CRPD), employment access and inclusion, subminimum wage, education outcomes, Medicaid managed care, mental health care, and data trends in disability policy.