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Managed Long-Term Services and Supports: 2012 Report to the President

This report provides background on MLTSS to brief the intellectual and developmental disability community, as well as the President and the Secretary of the Department of Health and Human Services, on managed care and changes in LTSS administration so that they may take action and influence outcomes. The report also contains a number of recommendations related to disability stakeholder engagement, choice and self-determination, consumer protections and rights and quality measurement.

Short URL: http://www.advancingstates.org/node/53399

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Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS

This policy brief provides a comparison of CMS’ finalized memoranda of understanding with California, Illinois, Massachusetts, Ohio, and Virginia to test a capitated model and with Washington to test a managed fee-for-service (FFS) model to integrate care and align financing for dual-eligibles. These 2013 demonstrations will introduce changes in the care delivery systems and will test a new system of payments and financing arrangements among CMS, the states and providers.

Short URL: http://www.advancingstates.org/node/53397

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A State-by-State Snapshot of Poverty Among Seniors: Findings from Analysis of the Supplemental Poverty Measure

The Census Bureau created the supplemental poverty measure, in an effort to differently reflect cost of living and financial status from the "official" measure. Poverty rates among older adults are higher under the supplemental poverty measure (15%) than under the official poverty measure (9%). This analysis does a state-by-state comparison using both poverty measures to describe seniors living in poverty. An understanding of elder financial hardship is important for fiscal policy debate.

Short URL: http://www.advancingstates.org/node/53396

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The Managed Fee-for-Service Option to Integrate Care for Dual-Eligibles: A Guide for State Advocates

CMS created a financial alignment demonstration to better promote coordinated care for dual-eligibles. The fee-for-service managed care model has received less attention than capitated managed care. However, this model could be useful in states or regions where traditional managed care organizations are not well established or do not function well. This brief makes some assessments of the advantages and difficulties of the model and identifies elements necessary for successful implementation.

Short URL: http://www.advancingstates.org/node/53395

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Guidance to States using 1115 Demonstrations or 1915(b) Waivers for Managed Long Term Services and Supports Programs

CMS has released two important documents that outline essential elements of MLTSS programs that are in line with current best practices. The first document summarizes these essential elements and the second provides guidance for incorporating these essential elements into MLTSS programs operating under section 1115 or 1915(b) authorities. These standards will be used when CMS reviews states’ design, implementation and operation of MLTSS programs for approval and ongoing quality assurance.

Short URL: http://www.advancingstates.org/node/53394

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Money Follows the Person (MFP) Rebalancing Demonstration: A Work in Progress

Money Follows the Person (MFP) federal grants are provided to states in order to assist older adults and people with disabilities in transitioning from nursing facilities to home and community based settings. A history and current state of MFP are offered. This report provides an overview of how MFP has helped states to rebalance their LTSS programs and provides next steps and an outlook for the future of MFP or similar programs once the demonstration project’s funding has run out.

Short URL: http://www.advancingstates.org/node/53392

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At the Crossroads: Providing Long-Term Services and Supports at a Time of High Demand and Fiscal Constraint

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.

Short URL: http://www.advancingstates.org/node/53391

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The Continuity of Medicaid Coverage: An Update

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.

Short URL: http://www.advancingstates.org/node/53389

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Health Equity and LGBT Elders of Color

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.

Short URL: http://www.advancingstates.org/node/53386

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Long-Term Care: Perceptions, Experiences and Attitudes Among Americans 40 or Older

A representative sample of 1,019 adults ages 40 or older were interviewed regarding their experiences and beliefs about their need for long-term care services, what such care would cost, and how such issues fit into their concerns about growing older. This report outlines survey findings. Findings include, 58% of participants underestimate the cost of nursing homes, 41% have discussed long-term care preferences with family and 51% support a government sponsored long-term care insurance program.

Short URL: http://www.advancingstates.org/node/53384

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