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  • Roads to Community Living: A Closer Look at Washington State’s Money Follows the Person Demonstration

    Report

    This case study looks at Washington state's Money Follows the Person demonstration program, Roads to Community Living. The program is responsible for assisting over 2,400 Medicaid beneficiaries with complex long-term services and supports (LTSS) needs in transitioning out of institutions back to community-based care settings. Washington State has been a leader in Medicaid LTSS rebalancing efforts over the last two decades. According to the state, in the early 1990s, 82 percent of long-term care funding…

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

    Report

    This case study looks at Michigan's Money Follows the Person (MFP) demonstration program, which has enabled the state to accelerate existing transition activities and increase access to home- and community-based services (HCBS) by providing enhanced federal funds for each MFP participant’s 365-day enrollment period. Through MFP, Michigan is able to provide a comprehensive set of demonstration services in addition to existing HCBS waiver services so that each MFP participant receives the services necessary to transition…

  • Implementation of Affordable Care Act Provisions to Improve Nursing Home Transparency, Care Quality, and Abuse Prevention

    Report

    The Affordable Care Act (ACA) is the first comprehensive legislation since the Nursing Home Reform Act, part of the Omnibus Budget Reconciliation Act of 1987 (OBRA ’87), to expand quality of care-related requirements for nursing homes that participate in Medicare and Medicaid and improve federal and state oversight and enforcement. Despite the 1987 reforms, beginning in 1997, the Government Accountability Office issued more than 20 reports documenting serious quality of care problems in nursing homes…

  • The Medicaid Medically Needy Program: Spending and Enrollment Update

    Issue Brief

    This brief examines Medicaid's medically needy program, which gives states the option to extend Medicaid eligibility to those with high medical expenses whose income exceeds the maximum threshold, but who would otherwise qualify. It provides updated enrollment and spending figures on the medically needy using data through federal fiscal year 2009, and explains how individuals become eligible for the program and key considerations for policy discussions. Brief (.pdf)

  • Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

    Fact Sheet

    This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and the demonstrations in each state are set to begin in April 2013. Fact Sheet (.pdf)

  • Kaiser Family Foundation Resources on Deficit-Reduction Debate

    Report

    These Foundation resources shed light on how the ongoing national debate about deficit reduction may affect Medicare, Medicaid and other health-care programs. These resources include analysis of specific savings proposals, polling on the public’s views of deficit-reduction options, summaries and comparisons of relevant elements of major deficit-reduction plans, and explanatory briefs and backgrounders describing key issues related to the debate. Drew Altman: The News Media and Entitlement Reform   Medicare-Specific Analysis Policy Options to Sustain…

  • Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…

  • State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS

    Report

    The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of these models. CMS is presently reviewing the states' proposals to determine which will be implemented. This background paper examines the contents of the 26 states'…

  • Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

    Issue Brief

    This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending.…

  • Articles Examine Data and Issues For Expanding Integrated Care Models For Dual-Eligible Beneficiaries

    Report

    As state and federal policymakers move to develop and test integrated care models for people dually eligible for Medicare and Medicaid, two new Kaiser Family Foundation articles in the June 2012 issue of Health Affairs highlight the diverse needs and challenges facing these 9 million beneficiaries, describe their current care arrangements, and raise issues to consider for proposed reforms aimed at better coordinating their care and reducing health care spending. The first highlights the diversity…