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  • Changes in Characteristics, Needs, and Payment for Care of Elderly Nursing Home Residents: 1999 to 2004

    Report

    The proportion of elderly adults over age 65 in nursing homes has declined over the past two decades, most noticeably in recent years. Reasons suggested for this trend include reductions in disability rates among elderly people, improvements in mechanisms for coping with disability, and changes in the residential and long-term care options available to elderly people with disabilities. This report focuses on the characteristics, needs, and payment sources for the care of elderly nursing home…

  • Chronic Disease and Co-Morbidity Among Dual Eligibles: Implications for Patterns of Medicaid and Medicare Service Use and Spending

    Report

    The health reform law contains provisions that aim to improve the delivery and coordination of services for persons enrolled in both Medicaid and Medicare, known as the dual eligibles. This population includes individuals with some of the most severely disabling chronic conditions. While the higher costs associated with services to dual eligibles is well-known, information on how spending is distributed across these programs is less understood. This study uses linked Medicare and Medicaid data to…

  • A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community

    Issue Brief

    The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care. The Affordable Care Act (ACA) provides incentives for…

  • 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…

  • Vermont’s Choices for Care Medicaid Long-Term Services Waiver: Progress and Challenges As the Program Concluded Its Third Year

    Report

    Vermont's Choices for Care experiment in long-term services, created through a five-year Medicaid waiver in 2005, was designed to increase access to home and community-based services while reducing the use of institutional services and controlling overall costs. In exchange for agreeing to a federal funding cap, Vermont was able to expand access to community-based services and extend some services to a "moderate need" group for the first time to test the theory that early interventions…

  • The Role of Health Coverage for People with Disabilities

    Event Date:
    Event

    People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing and paying for care. Report Chartpack Health Affairs Article-- "Uncovering the Health Challenges Facing People with Disabilities: The Role of Health Insurance"

  • Medicaid Benefits: California

    Other Post

    Completed for the National Conference of State Legislatures and the Kaiser Commission on Medicaid and the Uninsured, by Health Management Associates. Compiled from Medicaid State Plans and Amendments approved by the Centers for Medicare and Medicaid Services, and from State websites, with verification by State and Territorial Medicaid officials in March 2003.

  • Ongoing Impacts of the Pandemic on Medicaid Home & Community-Based Services (HCBS) Programs: Findings from a 50-State Survey

    Issue Brief

    This issue brief presents the latest findings on key state policy choices about Medicaid HCBS in 2022 based on the 20th KFF survey of state officials administering Medicaid HCBS programs in all 50 states and DC. The data were collected from April through September 2022. The survey was sent to each state official responsible for overseeing the administration of HCBS benefits (e.g., home health, personal care, and services for specific populations such as people with…

  • 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

  • State Options to Expand Medicaid HCBS: Examples & Evaluations of Section 1115 Waivers

    Issue Brief

    States are currently developing plans to access an increased federal matching rate (“FMAP”) for Medicaid HCBS spending established in the American Rescue Plan Act (ARPA) of 2021. In the future, states may also be able to access increased HCBS funds proposed in the Biden Administration’s American Jobs Plan and the Better Care Better Jobs Act recently introduced in Congress. This brief highlights examples of Medicaid HCBS policy changes authorized through Section 1115 demonstration waivers in…