Reports

This report is composed annually by the Data and Systems Group (DSG) of the Centers for Medicare & Medicaid Services (CMS). It provides descriptions of the states’ Medicaid managed care programs as of July 1, 2011. The report is organized by 1915(b), 1115, 1932(A), 1915(A), Concurrent 1915(B/C), Concurrent 1915(A/C), 1932, 1937, and PACE programs.

This report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. It provides national-level summary tables relating to trends, breakout of managed care entities, managed care enrollment by state, regional breakout and states with comprehensive health care reform demonstrations. The information was collected from State Medicaid agencies and CMS Regional Offices.

This report examines how health care outcomes for general medical care have been assessed for people with disabilities within the rubrics of care coordination and quality improvement. A total of 15,513 articles were screened; very few were direct examples of work conducted from the perspective of disability as a complicating condition. Capturing the disability perspective will require collaboration of measurement efforts across medical interventions, rehabilitation, and social support provision.

This report compares long-term care (LTC) for older adults delivered through Home and Community-Based Services (HCBS) with care provided in nursing homes (NHs) by evaluating (1) the characteristics of older adults served through HCBS and in NHs; (2) the impact of HCBS and NH care on outcome trajectories of older adults; and (3) the per person costs of HCBS and NH care, costs for other services such as acute care, and family burden.

This report details development of the Agency for Healthcare Research and Quality (AHRQ)’s Quality Indicators (QI) for the HCBS population. It includes key sections: 1) the introduction section providing background on the HCBS QI development project. 2) the methods section on an overview of the QI development process, 3) results of details of empirical analyses performed to support QI, 4) the concluding thoughts section providing a discussion of interpretation of the indicators.

The Agency for Healthcare Research and Quality (AHRQ) was assigned to develop outcome indicators to assess the "health and welfare" of recipients of Medicaid HCBS. AHRQ also was required to use the outcome indicators to describe the health and welfare of this population. The outcome indicators are presented by individual attributes and area characteristics. The health of the HCBS population is also described within the context of State policies and service availability.

The purpose of this literature review is to better understand the various pathways to Medicare-Medicaid eligibility, how and why and individual becomes eligible for both programs. Also, this report presents examples of federal government- and state-sponsored programs and supports aimed at delaying or preventing a descent into functional decline and/or poverty. The ways to simplify the enrollment process for those who quality and need Medicare and Medicaid benefits are discussed as well.

This paper discusses the progress states have made in moving away from institutional care for Long-Term Supports and Services and toward home and community-based programs. It analyzes the opportunities available through the Affordable Care Act and other programs whereby states can continue that progress even in a challenging budget environment.

This study focuses on new Medicare-Medicaid enrollees in Maryland and the circumstances that shaped their initial eligibility for both programs. This report details the demographic and programmatic characteristics of new enrollees. Specifically, it serves as the vehicle for establishing an initial operational definition of new enrollees and developing the terminology needed to describe the circumstances surrounding initial Medicare-Medicaid eligibility.

This report describes and analyzes chronic disease patterns and health care expenditures of persons in Maryland who in 2008 began to receive coverage from both Medicare and Medicaid. The analysis focuses on disease and expenditure patterns in the year before these individuals, most of whom had been enrolled in Medicare alone or Medicaid alone, became enrollees in both programs. The results can provide a better understanding of simultaneous enrollment in Medicare and Medicaid.