Sustainability

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Dual-Eligible Beneficiaries of Medicare and Medicaid: Characteristics, Health Care Spending, and Evolving Policies

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.

Short URL: http://www.advancingstates.org/node/53408

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Characteristics and Service Use of Medicaid Buy-In Participants with Higher Incomes: A Descriptive Analysis

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.

Short URL: http://www.advancingstates.org/node/53407

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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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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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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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Health Home Information Resource Center

The Affordable Care Act authorized the Medicaid Health Home State Plan Option, which allows states to design health homes to provide comprehensive care coordination for Medicaid beneficiaries with chronic conditions. States will receive enhanced federal funding to support the rollout of this new integrated model of care. This link directs to the Health Home Resource Center that provides technical assistance services for states as they submit their proposals for these health homes to CMS.

Short URL: http://www.advancingstates.org/node/53385

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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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A Profile of Older Americans: 2012

This annual summary uses information from the US Census Bureau, the National Center for Health Care Statistics, and the Bureau of Labor Statistics to display the demographic shift, as well as the health, geographic distribution and economic changes of those over 65 in the United States. This report found that 13.3 percent of the population is 65 and older, but this demographic is expected to grow to 21 percent by 2040. Changes from previous summaries are analyzed and projections are made.

Short URL: http://www.advancingstates.org/node/53380

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Putting your Aging and Disability Partnerships to Work for Your Bottom Line

This webinar examined how you can build on partnerships to take advantage of new funding opportunities, expand funding, and share resources with partners on grant writing and business development. Specifically, participants will be able to 1) understand why and how partnerships are beneficial to a sustainable program, 2) learn how to integrate opportunities for collaboration between disability and aging service systems, and 3) learn the concept of program sustainability and why it is important.

Short URL: http://www.advancingstates.org/node/53292

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