Care

Many individuals with long-term services and supports (LTSS) needs either reside in institutions or are at risk for institutionalization. Rebalancing care to provide LTSS in the community is one goal of the federal Financial Alignment Initiative for Medicare-Medicaid enrollees. This profile details the experiences of the Health Plan of San Mateo (HPSM) as it implements a pilot program to help dually eligible individuals in nursing facilities transition back to community living.

The Alzheimer's Association convened the Alzheimer's Association National Plan Care Support Milestone Workgroup, including experts in clinical care, long-term services and supports, dementia care, and support research, and public policy. The workgroup reviewed the current literature regarding Alzheimer's support and care in the U.S. and on a global scale, and developed several milestones to help create a better care and support system.

The Centers for Medicare & Medicaid Services (CMS) began the Financial Alignment Demonstration in 2013 to improve care coordination. GAO was asked to examine care coordination under this demonstration. On January 19, The Government Accountability Office publicly released a report with their recommendations for CMS. GAO recommends that CMS develop new measures and align the current measures to improve oversight of care coordination.

The Center for Health Care Strategies (CHCS), in partnership with Mathematica Policy Research and Airam Actuarial Consulting, released an issue brief on the state considerations when setting capitation rates for Medicaid Managed Long-Term Services and Supports (MLTSS) programs. CHCS and its partners examined the considerations taken by eight states (Arizona, Kansas, Massachusetts, Minnesota, Tennessee, Texas, Virginia, and Wisconsin) as they established their MLTSS rates.

The National Center for Health Statistics (NCHS) has four new reports available from the National Study of Long-Term Care Providers (NSLTCP). The data briefs and state tables use survey data from NCHS’ 2014 NSLTCP. NSLTCP provides reliable, accurate, relevant, and timely statistical information to support and inform long-term care services policy, research, and practice.

The Integrated Care Resource Center released a brief that offers tips for engaging providers in integrated care programs for Medicare-Medicaid enrollees. Integrated care programs are successful when a broad spectrum of providers are engaged in the process. This brief provides states with tips on how to engage physicians, hospitals, nursing facilities, and community-based service providers that serve Medicare and Medicaid enrollees.