Medicaid Managed Long Term Care

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Transitioning Long Term Services and Supports Providers Into Managed Care Programs

This paper identifies the concerns and considerations in transitioning traditional LTSS providers from fee-to-service models to a managed care program.The findings of the study are based on qualitative interviews conducted with a variety of stakeholders, including state Medicaid program officials, representatives from managed care companies, LTSS providers, LTSS provider associations, and private consultants.

Short URL: http://www.advancingstates.org/node/65883

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Strengthening Long-Term Services and Supports: A Tool to Assess and Improve Medicaid Managed Care

This tool promotes consumer-focused MLTSS by making it easier to identify weaknesses and promote better practices. The tool combines a checklist for assessing MLTSS with examples of practices, policies or contract language that implement the criteria.

Short URL: http://www.advancingstates.org/node/65878

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2014 State of the States in Aging and Disabilities

In 2014, ADvancing States surveyed state aging and disability agencies regarding the significant policy, fiscal, and operational issues occurring within each state. The survey collected detailed information about the structure of agencies, the supports provided, and the populations served by aging and disability agencies. Of particular interest is the summary of services provided in Medicaid waivers across the country. All of this information is presented in the charts accompanying this document.

Short URL: http://www.advancingstates.org/node/65688

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Participant-Directed Services In Managed Long-Term Services And Supports Programs: A Five State Comparison

At the beginning of 2013, 16 states had Medicaid managed long-term services and supports (MLTSS) plans, with mandatory or voluntary enrollment. Target populations varied by state. In 13 states, MLTSS plan members were afforded the choice to participant-direct (PD) at least some HCBS services. Based on 5 in-depth state case studies expectations regarding availability and take-up of PD services in MLTSS varied as did methods of communicating expectations. PD varied from 1.2% in AZ to 24% in NM.

Short URL: http://www.advancingstates.org/node/61410

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Application of Existing External Quality Review Protocols to Managed Long Term Services and Supports

This guidance document is intended to provide guidance to states on how to apply the revised protocols for External Quality Review (EQR) of Medicaid managed care organizations, released in 2012, to managed long term services and supports (MLTSS) programs. Although the protocols already apply to MLTSS generally, this document offers specific suggestions to make their application to long term services and supports (LTSS) clearer and provides suggestions, examples and illustrations.

Short URL: http://www.advancingstates.org/node/60531

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Two-Thirds of States Integrating Medicare and Medicaid Services for Dual Eligibles

New research from AARP and ADvancing States finds that two-thirds of states either have or will launch new initiatives to better coordinate care for people who are dually eligible for Medicare and Medicaid services over the next two years. To contain the growth of costs and improve care, many are moving to risk-based managed long-term services and supports models. This research finds that a number of states are exploring approaches to dual services integration outside of the CMS models.

Short URL: http://www.advancingstates.org/node/53368

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Analysis of the National Commission on Fiscal Responsibility and Reform

Bowles and Simpson, the co-chairs of the National Commission on Fiscal Responsibility and Reform drafted their recommendations to achieve fiscal sustainability. This analysis provides an overview of the commission’s formation, its structure and recommendations, and its potential impact on the aging and disability networks. The report’s legislative recommendations have implications for Medicaid, Medicare, Social Security, Community Living Assistance Services and Supports (CLASS), and more.

Short URL: http://www.advancingstates.org/node/53149

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2012 State of Aging and Disabilities Survey: Another Year of Challenges Tempered by Opportunities

State aging and disability agencies have operated within a tumultuous environment for the past several years. It has become increasingly more difficult to reconcile the needs of older adults and people with disabilities with the resources available to address those needs. Five themes are identified from the 2012 state of aging and disabilities surveys, which include the acceleration of Medicaid managed long term services and supports and continuing loss of historical knowledge around the nation.

Short URL: http://www.advancingstates.org/node/53349

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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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