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  • Emerging Medicaid Accountable Care Organizations: The Role of Managed Care

    Issue Brief

    This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs. An ACO is a provider-run organization in which participating providers are collectively responsible for the care of an enrolled population, and may share in any savings associated with improvements in the quality and efficiency of care. The structure of Medicaid ACO initiatives is influenced by individual states’ experience with managed care, other existing care delivery…

  • An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees

    Issue Brief

    Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans that seek to integrate benefits and align financial incentives between the two programs. On January 25, 2012, CMS issued a memorandum providing additional guidance for…

  • People with Disabilities and Medicaid Managed Care: Key Issues to Consider

    Issue Brief

    As many states expand their use of managed care in Medicaid, a growing number of beneficiaries with disabilities are being enrolled in risk-based managed care arrangements for at least some of their care. Further growth in managed care is expected in 2014, when the Affordable Care Act expands Medicaid eligibility to many uninsured low-income adults, including those with disabilities. This issue brief looks at issues related to the development and implementation of managed care programs…

  • Money Follows the Person: A 2011 Survey of Transitions, Services and Costs

    Issue Brief

    With the passage of health reform, the Money Follows the Person (MFP) demonstration grant program was extended through 2016 giving states further options to transition Medicaid beneficiaries living in institutions back to the community. Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the MFP demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. A total…

  • Case Study: Georgia’s Money Follows the Person Demonstration

    Issue Brief

    This brief reports on a case study of Georgia's Money Follows the Person (MFP) demonstration program, describing key features of the program and highlighting recent program experiences. The Georgia Department of Community Health (DCH) implemented the program in September 2008. In 2005, before the demonstration began, Georgia’s long-term care expenditures were $1.5 billion, with 70 percent devoted to institutional long-term care and 30 percent on home and community-based services (HCBS). One goal of the demonstration…

  • Georgia’s Money Follows the Person Program: Helping People Move Back Home

    Issue Brief

    This brief profiles several Georgia residents who have participated in the state's Money Follows the Person demonstration program, which helps transition people from institutional long-term care back into their homes or the community. It is part of a larger package of resources examining the Money Follows the Person program. Profiles (.pdf)

  • Long-term Services and Supports: A Rebalancing Act

    Event Date:
    Event

    The ongoing debate over the federal budget and deficit reduction presents a balancing act for policymakers, as many compelling interests compete for scarce dollars. But for 10 million older adults and people with disabilities who need long-term services and supports, there is a "rebalancing act" in progress. The aim is to serve more people at home and in the community, and fewer people in institutions. Are there sufficient home- and community-based programs in all states…

  • Examining Medicaid Managed Long-Term Service and Support Programs: Key Issues To Consider

    Issue Brief

    There is increased interest among states in operating Medicaid managed long-term services and support (MLTSS) programs rather than paying for long-term services and supports (LTSS) on a fee-for-service basis, as has been the general practice. This issue brief examines key issues for states to consider if they are contemplating a shift to covering new populations and LTSS benefits through capitated payments to traditional risk-based managed care organizations (MCOs). It draws on current literature as well…

  • State Options That Expand Access to Medicaid Home and Community-Based Services

    Report

    This background paper examines various aspects of the Medicaid program that can expand access to home and community-based services (HCBS) and rebalance long-term care spending in favor of HCBS. As a result of the long-standing requirement that states cover facility-based care, the majority of Medicaid long-term care (LTC) expenditures historically have been for institutional, rather than home and community-based, services. Over the past two decades, major efforts have been undertaken by states and the Centers…

  • Medicaid’s Long-Term Care Users: Spending Patterns Across Institutional and Community-based Settings

    Issue Brief

    The nation's primary payer for long-term services and supports, Medicaid finances 43 percent of all spending on long-term care services and covers a range of services and supports, including those needed by people to live independently in the community, as well as services provided in institutions. This report provides an overview of long-term care users and their acute and long-term care service spending. The report finds that although the individuals who rely on long-term care…