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  • Key Issues in Medicaid and Home and Community-Based Services and Support

    Issue Brief

    These briefs examine current issues in providing more people who need long-term care services and supports access to these Medicaid services in home and community-based settings rather than in institutional ones. The first brief, Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts , highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates…

  • Efforts in States to Promote Medicaid Community-Based Services and Supports

    Issue Brief

    This brief summarizes lessons in offering more home and community-based services from states at the forefront of the effort. It describes current options for state Medicaid programs and draws on interviews with state officials to provide details about specific policies and procedures in states. Brief (.pdf)

  • 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…

  • Frontline Perspectives on Long-Term Care Financing Decisions and Medicaid Assets Transfer Practices

    Report

    Frontline Perspectives on Long-Term Care Financing Decisions and Medicaid AssetsTransfer Practices In the Deficit Reduction Act of 2005, Congress tightened Medicaid asset transfer rules for individuals qualifying for Medicaid assistance with nursing home bills. Research on asset transfer shows a low incidence of asset transfers and limited cost savings from tightening such rules. But, because of demographic trends that will increase pressure on Medicaid and concerns that the Medicaid program may be financing care for…

  • Beyond Cash and Counseling: An Inventory of Individual Budget-based Community Long-Term Care Programs

    Issue Brief

    Beyond Cash and Counseling: An Inventory of Individual Budget-based Community Long-Term Care Programs This brief describes the evolution of beneficiary-managed home and community-based services since the original demonstration and provides an overview of state activity as of January 2006. The Deficit Reduction Act of 2005 gives states the option to use this model for an expanded range of home and community based services in their state Medicaid plans without having to obtain a waiver. Issue…

  • Dual Eligible Home and Community-Based Waiver Program Participants and the New Medicare Drug Benefit

    Issue Brief

    Dual eligible beneficiaries who participate in Medicaid home and community-based waiver programs usually do not have a centralized care provider to manage their health care benefits and services. For the new Medicare prescription drug benefit, no individual is designated to assist participants with their prescription drug plan selection, comparison of formularies, and if necessary, management of their exceptions and appeals should a medication be denied by their plan. This paper offers state and federal policymakers…

  • State Perspectives on Medicaid Long-term Care: Report from a July 2003 State Forum

    Report

    This report summarizes discussions on Medicaid and long-term care at a forum with state officials held by the Kaiser Commission on Medicaid and the Uninsured in July of 2003. The forum, conducted by the National Academy of State Health Policy, addressed issues including Medicaid's role in long-term care, state fiscal crises and cost-containment strategies, and how state long-term care programs are evolving. Report (.pdf)

  • Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance

    Issue Brief

    Asset Transfer and Nursing Home Use: Empirical Evidence and Policy Significance Due to concern that wealthy elderly Americans were transferring assets to gain Medicaid coverage for nursing home care, the Deficit Reduction Act (DRA) of 2005 tightened Medicaid eligibility rules related to asset transfers. About 43 percent of all nursing home residents eventually become Medicaid eligible. This brief concludes that for people becoming Medicaid eligible at the time of nursing home admission, 50 percent had…

  • Olmstead at Five:  Assessing the Impact

    Report

    This report examines the impact of Olmstead v. L.C. five years after the United States Supreme Court’s 1999 landmark decision. The analysis brings together new research with a synthesis of research undertaken over the past five years, to help policymakers and program administrators understand the meaning of the Americans with Disabilities Act for health programs in Olmstead’s aftermath. Report (.pdf) Related Olmstead Materials