Medicaid Waivers

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Gradual Rebalancing of Medicaid Long-Term Services and Supports

A statistical model was developed to assess the effect of rebalancing on overall spending for long-term services and supports (LTSS). The model indicates that spending is affected by the way rebalancing is implemented: Gradual rebalancing can reduce spending by about 15 percent over ten years. Because many states continue to experience budget crises, policy makers must think carefully before altering spending patterns for LTSS and adopt strategies to successfully reduce overall spending.

Short URL: http://www.advancingstates.org/node/53136

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Oversight of Quality of Care in Medicaid Home and Community-Based Services Waiver Programs

States provide long-term care services in homes and community-based settings through 1915(c) home and community-based services (HCBS) waiver programs. To ensure strong oversight of waiver programs, this report reviews documents from CMS's most recent quality review of waiver programs from 25 States, as well as information gathered from structured interviews with staff from the 10 CMS regional offices. The report also identify five recommendations to meet assurances related to quality of care.

Short URL: http://www.advancingstates.org/node/53133

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An Overview of Recent Section 1115 Medicaid Demonstration Waiver Activity

Section 1115 waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states significant flexibility in how they operate programs and can have a significant impact on program financing. As such, waivers have important implications for beneficiaries, providers, and states. This brief provides an overview of Section 1115 waiver authority, the waiver approval process, and recent waiver activity and discusses the implications.

Short URL: http://www.advancingstates.org/node/53112

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Medicaid Financing for Services in Supportive Housing for Chronically Homeless People: Current Practices and Opportunities

In 2014, most homeless people will become Medicaid-eligible under the Affordable Care Act. Many homeless people have physical and behavioral health conditions for which they seek care through frequent use of emergency rooms and inpatient hospitalization, at considerable cost in public resources. Medicaid reimbursement is an important source of funding for services that help homeless people succeed in housing and stop such inappropriate use of crisis health services.

Short URL: http://www.advancingstates.org/node/53101

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Medicaid and HCBS Data Update – PAS Center

This portion of the Center for PAS website presents various data and resources related to Personal Assistance Services by state. Recent updates include two sets of information concerning Medicaid home-and community-based services (HCBS). Users can select a state or select a specific topic such as state statistics, program data, and other PAS projects.

Short URL: http://www.advancingstates.org/node/53096

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A National Review of Home and Community Based Services (HCBS) for Individuals with Autism Spectrum Disorders

Autism spectrum disorders are among the fastest-growing developmental disability diagnosis in the US. This growing number highlights the need to learn more about the services & supports that are currently available for adults with ASD, & consider those that will be needed throughout their adult lifespan. The purpose of the study was to investigate how people with ASD are being served across states in HCBS, including service eligibility, state trends specific to autism services & lessons learned.

Short URL: http://www.advancingstates.org/node/53094

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Self-Determination and the MI Choice Medicaid Waiver Program: A survey of direct care workers serving people using the MI Choice self-determination option

The goals of the survey, which was sent to direct-care workers serving participants using the MI Choice SD option, were to: collect baseline demographic information on workers in the SD option; understand the motivations, job satisfaction, and training needs of workers providing services and supports to self-directed participants; and,identify strategies to strengthen and support the recruitment and retention of workers in self-directed programs.

Short URL: http://www.advancingstates.org/node/53088

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California and Texas: Section 1115 Medicaid Demonstration Waivers Compared

Both of these large state waivers affect hundreds of thousands of Medicaid beneficiaries, involve billions of federal Medicaid matching funds, and are designed, in part, to promote changes in the health care delivery system that will result in better care for individuals, better population health, and reductions in costs through system improvements. They have a number of key similarities and differences as summarized in the side-by-side table within this fact sheet.

Short URL: http://www.advancingstates.org/node/53080

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Medicaid.gov Website

Have you seen the new site sponsored by CMS? This space offers a resource center for states, up to date information about the affordable care act and additional federal policy guidance. The waiver section organizes information by state, program name, waiver authority and status of a application. This chart gives an overview of the four primary types of waivers and demonstration projects: Section 1115, Section 1915(b) Managed Care, Section 1915(c) HCBS, and Concurrent Section 1915(b) and 1915(c).

Short URL: http://www.advancingstates.org/node/53071

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Using Medicaid Funding to Support the Employment of People with Disabilities: A Federal Framework

State Medicaid agencies fund supports & services for individuals with disabilities. As national public policy recognizes & emphasizes the ability of individuals with disabilities to work, states are integrating employment supports into the continuum of long-term care in Medicaid. This brief discusses federal legislative & regulatory framework for funding employment supports in Medicaid, highlights examples of state innovations & best practices to promote positive employment outcomes.

Short URL: http://www.advancingstates.org/node/53061

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