Research / Journal abstracts

Review a summary report of the Patient Protection and Affordable Care Act (ACA) provisions that have a direct or indirect impact on the workforce caring for the elder population, explores the challenges to developing the workforce, and critiques the adequacy of the ACA provisions in meeting those challenges. The ACA acknowledges gaps in the workforce caring for the elder population. Still, its provisions are inadequate given insufficient supply in the number and types of workers.

The purpose of this study was to describe the two ways in which Medicaid offers personal care services to low-income Americans: Medicaid Title XIX Personal Care Services (PCS) optional state plan benefit; and the Medicaid 1915(c) Home and Community-Based Services (HCBS) waivers program. A summary of the findings of this study are presented here as well as the article that appeared in the Health Care Financing Review, Summer 2001.

This issue brief uses the most recent comprehensive data, from 2009, to examine the characteristics and costs of dual-eligible beneficiaries. The report also examines the different payment systems that Medicare and Medicaid use to fund care for dual-eligible beneficiaries and recent efforts at the federal and state levels to integrate those payment systems and coordinate the care between both programs. Given the high cost of dual-eligibles, legislative solutions are reviewed.

Few employer-sponsored and private insurance plans offer the range of services that workers with disabilities may need. Medicaid Buy-In programs are a viable option that allows these workers to receive needed services without spending down for Medicaid. This report describes findings from a study of characteristics and service utilization of higher-income enrollees compared to regular Medicaid enrollees. Providing these programs may keep higher-income workers with disabilities employed.

A survey of state aging, disability and Medicaid agencies was conducted in 2012, in order to better understand challenges and concerns for funding and providing quality LTSS. Five common themes were identified in this report, including staff turnover and reductions during a sluggish recovery of state budgets. Other findings include an overall expansion of home and community-based services, LTSS transformation and reduced funding and high demand for non-Medicaid aging and disability services.

This report describes research conducted on the continuity of enrollment of Medicaid beneficiaries. Continuous enrollment in a health insurance plan promotes chronic disease management and is more cost-effective. The research found that Medicaid beneficiaries are on average enrolled in the program for just 9.7 months out of the year. This disruption in enrollment leads to higher monthly medical costs and interferes with efforts to measure quality of care delivered through Medicaid.

Ethnic minorities and LGBT older adults will continue to become more represented among the older adult population. A lifetime of discrimination has often adversely affected LGBT elders of color in a myriad of ways, including greater likelihood of financial instability and heightened health disparities. This report offers policy solutions to support the wellbeing of this growing population. Policy solutions include strengthened outreach and community supports to LBGT elders of color.