Medicaid Managed Long Term Care

The annual 2013 Medicaid Managed Care Enrollment Report created by the Division of Managed Care Plans and the Data and Systems Group in the Center for Medicaid and CHIP Services at CMS, with assistance from Mathematica Policy Research, was released this week. Data on Medicaid enrollment is collected from every state, territory, and the District of Columbia, and is broken down into categories by program, population, and state. The report provides tables with nationwide data and data by state.

The Milbank Memorial Fund released a new study, the Role of State Medicaid Directors: A Leadership Imperative. This study was authored by Andy Allison, a former Kansas and Arkansas Medicaid Director. The study focuses on the current climate of Medicaid policy, organizations and leadership. There is a specific focus on how the administration is structured for Medicaid in the states and the adequacy of state investments in the role and compensation of these leaders.

The results of the annual survey represent a snapshot of the current status of state government employees, the agencies that administer the programs, and the services that are provided. The 2015 survey revealed that states are continuing to address the same underlying challenges discussed in the previous reports.The report also includes summary tables that outline specific information about each individual state agency and LTSS program. Email adiaz@advancingstates.org to request a hard copy version.

The Center for Health Care Strategies released a brief, funded by the Commonwealth Fund, that examined member engagement approaches used by participating health plans in Promoting Integrated Direct Care for Eligibles (PRIDE). The brief highlights promising strategies for providing Medicare-Medicaid enrollees with complex medical, behavioral health, and social service needs. There is a specific emphasis on the approaches to building trusting relationships with members.

The white paper examines the impact that managed care organizations can have on cost and quality of care for older adults and people with disabilities. The National Council on Disability found that MCOs can lower the costs of services for these populations. However, MCOs must face the challenge of training staff on person-centered planning and competency for the quality of care to genuinely increase. This provides an analysis of the positives and negatives of MCOs and where to move from here.

The AARP Public Policy Institute released a new report conducted by Truven Health Analytics. The two part study examined Medicaid Managed Long Term Services and Supports program contracts in 18 different states for older adults and people with physical disabilities and case studies of new care coordination models in Ohio and Illinois. The findings indicate that states need care coordination and that these care coordinators provide crucial support for consumers and their family caregivers.

The UnitedHealth Center for Health Reform and Modernization released a new brief. Many Americans do not have health insurance coverage, and Medicaid enrollment can cover the gap of the uninsured, if successful practices are used. This brief highlights four approaches used in Kentucky and Arkansas to increase enrollment for low-income residents to cut their uninsured populations in half. The solutions in this brief can inform other states on efforts to decrease the number of uninsured people.

The second annual report to Congress examines the services utilized by Medicaid's behavioral health beneficiaries. The findings indicate that low-income children have high levels of unmet need in the mental health care arena. Additionally, the review of Medicaid's dental coverage found considerable variation between states, particularly for services provided to adults. The report findings illustrate the potential directions for change to improve care for beneficiaries.

Person-centered planning encompasses the idea that the individual is at the heart of all decisions about services, supports, and care. This report analyzes how well states are implementing a 2014 rule that creates the right to person-centered care planning for Medicaid consumers of Long-Term Services and Supports. The report is a tool for health care providers, plan administrators, and advocates to help them understand the scope of the rules and be able to identify provision shortfalls.

These are three case studies of LTSS services in Minnesota, Idaho, and Georgia done by the Public Policy Institute of AARP as follow-up studies to the Raising Expectations 2011 State Scorecard on LTSS. The State LTSS Scorecard examines states' performance across 25 indicators that comprise four key dimensions of a high-performing system.