Medicaid Managed Long Term Care

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June 2015 Report to Congress on Medicaid and CHIP

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.

Short URL: http://www.advancingstates.org/node/66568

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A Right to Person-Centered Care Planning

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.

Short URL: http://www.advancingstates.org/node/66400

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State Long-Term Services and Supports Scorecard: What Distinguishes High- from Low-Ranking States? Case Studies

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.

Short URL: http://www.advancingstates.org/node/66188

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Fostering Person-Centered Supports and Services in Michigan's Nursing Homes

As part of PHI's One Vision: Moving Forward project, Michigan long-term care stakeholders discussed the potential use of Medicaid financial incentives to encourage person-centered care in nursing homes.The resulting publication outlines the ideas and recommendations produced by the discussion. The stakeholders primarily considered metrics, such as resident and staff satisfaction, that could be used to quantify nursing homes' commitment to person-centeredness.

Short URL: http://www.advancingstates.org/node/66158

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Medicaid-Financed Institutional Services: Characteristics of Nursing Home and ICF/IID Residents and Their Patterns of Care

Despite states' rebalance of long-term care (LTC) systems with greater emphasis on home and community-based services (HCBS), many low-income elderly, persons with physical disabilities, and persons with intellectual/developmental disabilities continue to reside in institutions. Through an analysis of Medicaid enrollment and LTC claims data, this report provides information on the characteristics of institutionalized enrollees, their stays, and the interaction of institutional services and HCBS.

Short URL: http://www.advancingstates.org/node/65911

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An Investigation of Interstate Variation in Medicaid Long-Term Care Use and Expenditures Across 40 States in 2006

Shifting the balance in publicly-funded long-term care provision away from institutional care toward greater reliance on home and community-based services has been a federal goal for the past three decades -- a goal often referred to as "re-balancing" state LTC systems. This report explores inter-state variations in LTC expenditure and service use patterns, in terms of institutional and non-institutional services, and also by Medicaid LTC users' age and type of disability.

Short URL: http://www.advancingstates.org/node/65900

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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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