Reports

This report describes the process of assembling and integrating Medicaid and Medicare data to study recipients of HCBS in California. Subsequent reports will describe disability levels and service use of HCBS users in Medi-Cal only and dual eligibles between 2005 and 2008.

This report presents budgeting and contractual strategies used in Arizona, Hawaii, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, Pennsylvania, Tennessee, Texas, Washington and Wisconsin. In different ways, these states have made substantial progress in transforming their LTSS systems by developing flexible accounting policies that have reduced NF utilization and captured the savings to support their HCBS programs.

This policy brief from Georgetown University, produced with support from The SCAN Foundation, reviews Medicaid's importance and current funding limitations for long-term care and makes the case for strengthening Medicaid two possible ways - full federal responsibility for Medicare beneficiaries who also rely on Medicaid or an enhanced federal match for Medicaid long-term care services. Each approach carries with it a federal commitment to bear the brunt of a growing elderly population.

Medicaid program integrity is among the highest priorities of the nation’s Medicaid Directors and is a key component of every initiative and program states conduct. Program integrity is about creating a culture where there are consistent incentives to provide better health outcomes within a context that avoids over-or underutilization of services. Directors seek to promote economy, efficiency, accountability, and integrity in the management and delivery of services.

Person- and family-centered care (PFCC) has gained attention in recent years as a mechanism for transforming health care and long-term services & supports (LTSS). Research shows that PFCC improves quality of care & quality of life. The current shift in payment reform & service delivery away from disease or provider-focused models and toward incentives that reward better coordination, communication, and continuity of care, is likely to promote wider adoption and effective implementation of PFCC.

The Money Follows the Person (MFP) Demonstration supports state efforts to help Medicaid beneficiaries living in long-term care facilities transition back to community-based residences and to make community-based long-term care services and supports more accessible. This report uses aggregate data from annual financial reports and service claims records submitted by grantees to examine the costs and types of community-based services received by participants in the MFP program.

In the context of “rebalancing” efforts, the authors describe flexible accounting as budgeting practices and contractual language that incentivize the use of less expensive noninstitutional programs and use savings to expand lower-cost services to further reduce the state’s use of institutional care. The authors offer recommendations for California and pay special attention to flexible accounting in Medicaid managed LTSS and identify examples of flexible accounting practices.

State and local disability employment services are operated by a number of different public & nonprofit agencies. Organizations find it necessary to access funds from more than one program, agency, or funding stream. As a result, many program administrators & staff face the challenge of developing strategies to braid disability employment funding. This report profiles four programs that have implemented braided funding strategies to support hiring initiatives with employer partners.

The Exchange website offers busy health professionals and researchers a variety of opportunities to share, learn about, and ultimately adopt evidence-based innovations and tools suitable for a range of health care settings and populations. The site has the following components: Searchable innovations; Searchable QualityTools; Learning opportunities and Networking opportunities.

Each year, AoA compiles a summary of the latest statistics on individuals 65 years or older across 15 topical areas including income, poverty, employment, health, disability, and caregiving. This report has now been updated to reflect the most recent year for which data is available, 2010.