Research / Journal abstracts

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Characteristics and Service Use of Medicaid Buy-In Participants with Higher Incomes: A Descriptive Analysis

Few employer-sponsored and private insurance plans offer the range of services that workers with disabilities may need. Medicaid Buy-In programs are a viable option that allows these workers to receive needed services without spending down for Medicaid. This report describes findings from a study of characteristics and service utilization of higher-income enrollees compared to regular Medicaid enrollees. Providing these programs may keep higher-income workers with disabilities employed.

Short URL: http://www.advancingstates.org/node/53407

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At the Crossroads: Providing Long-Term Services and Supports at a Time of High Demand and Fiscal Constraint

A survey of state aging, disability and Medicaid agencies was conducted in 2012, in order to better understand challenges and concerns for funding and providing quality LTSS. Five common themes were identified in this report, including staff turnover and reductions during a sluggish recovery of state budgets. Other findings include an overall expansion of home and community-based services, LTSS transformation and reduced funding and high demand for non-Medicaid aging and disability services.

Short URL: http://www.advancingstates.org/node/53391

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The Continuity of Medicaid Coverage: An Update

This report describes research conducted on the continuity of enrollment of Medicaid beneficiaries. Continuous enrollment in a health insurance plan promotes chronic disease management and is more cost-effective. The research found that Medicaid beneficiaries are on average enrolled in the program for just 9.7 months out of the year. This disruption in enrollment leads to higher monthly medical costs and interferes with efforts to measure quality of care delivered through Medicaid.

Short URL: http://www.advancingstates.org/node/53389

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Health Equity and LGBT Elders of Color

Ethnic minorities and LGBT older adults will continue to become more represented among the older adult population. A lifetime of discrimination has often adversely affected LGBT elders of color in a myriad of ways, including greater likelihood of financial instability and heightened health disparities. This report offers policy solutions to support the wellbeing of this growing population. Policy solutions include strengthened outreach and community supports to LBGT elders of color.

Short URL: http://www.advancingstates.org/node/53386

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Examining the Experiences and Decisions of Parents/Guardians: Participant Directing the Supports and Services of Adults With Significant Intellectual and Developmental Disabilities

In this case study, the authors examined the decisions and experiences of parents/guardians who directed supports and services for an adult with significant intellectual and developmental disabilities (SIDD). Respondents included the parents/guardian of the adult as well as others in the circle of support identified by the parents/guardians.

Short URL: http://www.advancingstates.org/node/53359

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The Relationship between Older Americans Act Title III State Expenditures and Prevalence of Low-Care Nursing Home Residents

This paper aims at testing the relationship between older Americans Act (OAA) program expenditures and the prevalence of low-care residents in nursing homes (NHs). Principal findings indicate that increased spending on home-delivered meals was associated with fewer residents in NHs with low-care needs. States that have invested in their community-based service networks, particularly home-delivered meal programs, have proportionally fewer low-care NH residents.

Short URL: http://www.advancingstates.org/node/53336

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ACO and Patient-Centered Medical Home Models: Health Affairs Special Issue

The November 2012 issue of Health Affairs contains nine articles offering early insights on ACO and patient-centered medical home care delivery models. Both of these models have significantly developed in a relatively short period of time. Their goal is to further coordinate care and improve the health of patients. The nine articles examine whether either model will deliver major cost savings, especially in the short term.

Short URL: http://www.advancingstates.org/node/53322

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Effectiveness of the State Long Term Care Ombudsman Programs

This report serves as a follow-up to the 1995 Institute on Medicine (IOM) report which argued for an ombudsman program to address the quality of care in long-term institutional settings. This study investigates the role and effectiveness of the State Long-Term Care Ombudsman Programs (LTCOPs) in improving care. Surveys with all states/territories reveal new findings on the structure of the program in different states as well as their own perceived effectiveness. Comprehensive data and analysis.

Short URL: http://www.advancingstates.org/node/53184

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The Class Act: Is It Dead or Just Sleeping?

The Affordable Care Act (ACA) established a voluntary public insurance program for long-term care: the Community Living Assistance Services and Supports (CLASS) Act. In October 2011, the Obama Administration suspended the CLASS Act because of the high risk of fiscal insolvency. This article discusses several CLASS Act design and implementation issues, including the voluntary enrollment, the weak work requirement, the lifetime and cash benefits, and the premium subsidy for low-income workers.

Short URL: http://www.advancingstates.org/node/53140

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The Affordable Care Act and Long-Term Care: Comprehensive Reform or Just Tinkering Around the Edges?

This critical essay examines how effectively the Patient Protection and Affordable Care Act (ACA) addresses prevailing deficiencies in the nation's long-term care system and whether the ACA will result in meaningful reform. This article also reviews the basic problems plaguing the long-term care sector and the provisions within the ACA meant to address them, including incentives/options for expanding home- and community-based care and a number of research and demonstration projects.

Short URL: http://www.advancingstates.org/node/53138

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