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Health Affairs Blog: Can States Substantially Reduce Medicaid Spending Through Delivery System And Financing Reform?

In a Health Affairs blog post,  Joshua M. Wiener and Melissa Romaire of RTI International and MaryBeth Musumeci of the Kaiser Family Foundation examine whether states could successfully cope with substantial reductions in federal Medicaid funding under a per capita cap or block grant system by improving efficiency in the…

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CMS’s Final Rule on Medicaid Managed Care: A Summary of Major Provisions

On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.

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Medicaid’s Role for Seniors

This infographic highlights Medicaid’s role for seniors. It includes information about the senior population and highlights Medicaid’s role in increasing access to and financing treatment, particularly for long-term care. It also discusses the potential impact of proposals to limit federal Medicaid financing.

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Hotspot States See More COVID Cases in Nursing Homes

In his Axios column, Drew Altman discusses new data on the surge of new infections in long-term care facilities in COVID-19 hotspots. The dominant narrative about the Sunbelt surge in new cases is that the infected population is younger, but he says that’s not the whole story. There is also a spike in cases in long-term care facilities, especially in Florida and Texas.

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COVID-19 and Workers at Risk: Examining the Long-Term Care Workforce

The highly transmissible nature of the coronavirus combined with the congregate nature of long-term care facility settings and the close and personal contact that many long-term care workers have with patients puts them at elevated risk of infection. This analysis focuses on the characteristics of the 4.5 million people who work in long-term care settings, based on the 2018 American Community Survey.

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State Reporting of Cases and Deaths Due to COVID-19 in Long-Term Care Facilities

This data note provides detailed state-level data on numbers and shares of cases and deaths due to COVID-19 in long-term care facilities. This data note also provides information on state variation in LTC facility cases/deaths reporting patterns.

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More than 10,000 People in Long-Term Care Facilities Have Died Due to COVID-19

More than 10,000 residents and staff in long-term care facilities across the U.S. have died from COVID-19 infections, according to a KFF analysis of state data. That number is an undercount since not all states are currently reporting such data. Among those reporting data, the largest death tolls as of…

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COVID-19 Has Claimed the Lives of 100,000 Long-Term Care Residents and Staff

More than 100,000 residents and staff have died in long-term care facilities since the start of the pandemic. This post discusses the implications of the likely rise in cases due to holiday gatherings and the share of total COVID-19 deaths that have happened in long-term care facilities.

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Medicaid’s Money Follows the Person Program: State Progress and Uncertainty Pending Federal Funding Reauthorization

Medicaid’s Money Follows the Person (MFP) demonstration has helped seniors and people with disabilities move from institutions to the community by providing enhanced federal matching funds to states since 2007. The program operates in 44 states and has served over 90,000 people as of June 2018. The program is credited with helping many states establish formal institution to community transition programs that did not previously exist by enabling them to develop the necessary service and provider infrastructure. With a short-term funding extension set to expire on December 31, 2019, MFP’s future remains uncertain without a longer-term reauthorization by Congress.

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Implications of the Expiration of Medicaid Long-Term Care Spousal Impoverishment Rules for Community Integration

To financially qualify for Medicaid long-term services and supports (LTSS), an individual must have a low income and limited assets. In response to concerns that these rules could leave a spouse without adequate means of support when a married individual needs LTSS, Congress created the spousal impoverishment rules in 1988. Originally, these rules required states to protect a portion of a married couple’s income and assets to provide for the “community spouse’s” living expenses when determining nursing home financial eligibility, but gave states the option to apply the rules to home and community-based services (HCBS) waivers.
Section 2404 of the Affordable Care Act (ACA) changed the spousal impoverishment rules to treat Medicaid HCBS and institutional care equally from January 2014 through December 2018. Congress subsequently extended Section 2404 through December 2019. This issue brief answers key questions about the spousal impoverishment rules, presents 50-state data from a 2018 Kaiser Family Foundation survey about state policies and future plans in this area, and considers the implications if Congress does not further extend Section 2404.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in San Francisco, California.