Reports

This brief reviews Medicaid’s importance and limitations when it comes to long-term care and makes the case for strengthening Medicaid’s safety net in one of two ways—assumption of full federal responsibility for Medicare beneficiaries who also rely on Medicaid (so-called “dual eligibles”) or an enhanced federal match for Medicaid long-term care services.

Highlighted in the report are important developments & directions in NIH-funded research, including: risk for developing Alzheimer’s; genes that play a role in the disease; neuroimaging & biomarkers that detect & track the disease; research into new treatments; lifestyle factors that may worsen or protect against the disease; & help for caregivers. Special features include animation showing the progression of Alzheimer’s in the brain & video interviews highlighting new insights into the disease.

This guide lays out information about each federal program that provides or could provide respite funding or support. It is meant to be used by state Lifespan Respite Care Programs & their partners to help identify the funding sources that could be the building blocks for the state’s Lifespan Respite systems, help serve the underserved, build respite capacity & quality and help recruit & retain respite workers, and identify individuals who administer funds for future partnerships.

In its first year of operation, the Center for Medicare and Medicaid Innovation has a long list of accomplishments, yet some observers express concern that its fast-paced approach may be overwhelming to smaller delivery systems. A status report of the Innovation Center’s activities to date is provided, including delineating the goals envisioned by Congress, detailing the new tools it was given, and emphasizing how the enhanced authority compares with CMS’ traditional demonstration programs.

Overview provided about individuals and families who can be expected to receive assistance under insurance affordability programs, which include Medicaid, CHIP, advance premium tax credits and cost-sharing reductions, and Basic Health Programs. Particular focus is placed on the characteristics of individuals whose incomes place them at or near the Medicaid/exchange dividing line. The authors identify opportunities for greater collaboration and alignment in key areas.

The Affordable Care Act requires the Office of Inspector General to submit a report to Congress evaluating the law’s Nationwide Program for National & State Background Checks on Direct Patient Access Employees of Long Term-Care (LTC) Facilities within six months of the program’s completion. OIG recently conducted a survey of LTC provider administrators, & asked them about current practices regarding background checks on potential employees, & the effects of such programs on the LTC workforce.

Many states are undergoing long-term services & supports (LTSS) transformations. The lagging economy & increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs & another 11 with plans for implementation. Many states used the economic downturn as an opportunity to balance services from institutional to non-institutional settings.

Despite continued fiscal pressures on states, eligibility policies remained stable in nearly all state Medicaid and Children's Health Insurance Programs during 2011. Moreover, many states used technology to increase program efficiency and streamline enrollment. The "maintenance of eligibility" requirement in the Affordable Care Act (ACA) played a key role in preserving coverage levels. Without it, more states likely would have limited eligibility or tightened enrollment procedures.

Enrollment in MFP continued to grow steadily with 15,818 cumulative transitions to the community as of June 30, 2011, a 33 percent increase from the end of 2010. The states reported 3,722 new transitions during the six-month period from January to June 2011, 9 percent more than in the previous six-month period. The report provides an overview of state MFP grantee progress on key performance indicators and challenges states reported when implementing their transition programs.

State aging & disability agencies are operating in an era of state agency reorganization, re-conceptualization of state government, & restructuring of long-term services & supports delivery systems & financing. Key elements driving continued change include the economic environment, ACA implementation, uncertainty in the federal budget particularly with the failure of the Congressional Super Committee, changes in state level leadership, & the 2012 elections.