Medicaid Managed Long Term Care

This brief, a product of the Complex Care Innovation Lab made possible by Kaiser Permanente Community Benefit, outlines the current state of Medicaid NEMT services, its challenges, and opportunities for improvement. It explores alternative transportation models piloted by states and health plans across the country, including the use of transportation network companies, such as Uber and Lyft, to augment NEMT services.

On February 8th, the Government Accountability Office publicly released a report on Medicaid managed care and Long-term Services and Supports. The report examined MLTSS program goals, payment structures, financial incentives for plans, and federal monitoring programs. The report makes several recommendations for CMS.

The Center for Health Care Strategies, Inc. released a technical assistance brief, funded through support by the Robert Wood Johnson Foundation, titled "State Medicaid Managed Long-Term Services and Supports Programs: Considerations for Contracting with Medicare Advantage Dual Eligible Special Needs Plans."

During calendar year 2015, ADvancing States engaged in a collaboration with the DentaQuest Foundation to identify and promote effective oral health interventions for older adults and people with physical disabilities. This initiative involved collaborating with partners from the dental, aging, and disability fields in order to increase knowledge regarding issues and challenges related to dental services for older adults and people with disabilities.

This report represents two years of work by the HCBS Committee and and contains the Committee's final set of recommendations. It describes key components of a conceptual foundation for home and community based services (HCBS) quality measurement, specifically an operational definition of HCBS, a list of characteristics describing high-quality HCBS, and a measurement framework of 11 domains and 40 subdomains.

On Wednesday, July 20, 2016, the Center for Health Care Strategies, Inc. (CHCS) published a new brief, “State Trends in the Delivery of Medicaid Long-Term Services and Supports.” With support from The SCAN Foundation, seven states (Arizona, California, Kansas, Minnesota, New Jersey, Tennessee, and Texas) were selected to provide insights into current trends in both managed long-term services and supports (MLTSS) program refinement and long term services and supports (LTSS) system reform.

On Friday, July1, 2016, Mathematica Policy Research published a report summarizing the basic approach to rate-setting in Medicaid managed care and reviews the main options for structuring managed LTSS (MLTSS) rates. It presents examples from states with financial alignment demonstrations as well as long-standing MLTSS programs. The report concludes by highlighting the policy and operational considerations that should influence a state’s choice of strategy.

Gary Sullivan, a member of UnitedHealthcare in Tennessee, shares his perspective on the benefits he’s received from being a UnitedHealthcare member. Gary, who was a practicing attorney until his retirement, has been wheelchair-bound due to his muscular dystrophy for many years, and has significant need for help with activities of daily living.

CMS posted two new reports with Medicaid LTSS expenditures data. The first report focuses on the most recent data available and recent trends such as 1) an increase in LTSS provided in managed care programs and 2) increased used of newer Medicaid LTSS options authorized in the Deficit Reduction Act and the Affordable Care Act. The second report, “Improving the Balance,” uses data from FY1981 through FY2014 and documents the transition of Medicaid LTSS from institutional services to HCBS.

ADvancing States has released the association’s 2016 policy priorities. The priorities document outlines issues and recommendations regarding a wide range of health and human services programs important to older adults and people with disabilities. These include issues such as: • Implementation of the Older Americans Act reauthorization; • Medicaid LTSS innovations; • Support for caregivers; and • Employment for people with disabilities •