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  • Medicaid Long-Term Services and Supports: Key Considerations for Successful Transitions from Fee-For-Service to Capitated Managed Care Programs

    Issue Brief

    Although relatively few Medicaid beneficiaries are in capitated managed long-term services and supports (LTSS) programs, significant expansion is anticipated as more than half of states are implementing or proposing new programs that would include a transition from fee-for-service (FFS) to capitated managed care in the LTSS delivery system. By definition, these Medicaid beneficiaries need assistance with activities of daily living. Thus poor transitions, particularly those that lead to gaps in services, can have dire consequences.…

  • Medicaid Financial Eligibility: Primary Pathways for the Elderly and People with Disabilities

    Issue Brief

    This issue brief details the various eligibility pathways by which individuals with disabilities and the elderly can qualify for Medicaid coverage. The program, which serves as a safety net for many of the nation’s poorest and sickest individuals, provides health coverage to nearly 60 million Americans, including 8.5 million with disabilities and 8.8 million low-income frail, elderly and disabled Medicare beneficiaries who rely on Medicaid to fill Medicare’s gaps.  Issue Brief (.pdf)

  • Key Issues in State Implementation of the New and Expanded Home and Community-Based Services Options Available Under the Affordable Care Act

    Issue Brief

    This brief summarizes the key issues identified and discussed by participants in Kaiser Family Foundation’s Commission on Medicaid and the Uninsured's July 16, 2013 roundtable meeting on state adoption of the new and expanded Affordable Care Act home and community-based services (HCBS) options. While states have made overall progress in rebalancing their long-term care systems in favor of community-based care, state adoption of ACA HCBS options has been relatively slow to date, despite the growing…

  • Testimony: What would strengthen Medicaid Long-Term Services and Supports?

    Issue Brief

    On August 1, 2013, Diane Rowland, Executive Vice President of the Kaiser Family Foundation and Executive Director of the Foundation's Kaiser Commission on Medicaid and the Uninsured, testified before the Federal Commission on Long-Term Care about ways in which the Medicaid program could be strengthened to better support low-income individuals with long-term services and supports needs.

  • Improving the Financial Accountability of Nursing Facilities

    Report

    This report examines nursing facility expenditures to assess relative spending increases in areas such as nursing services, administrative costs, and profits. Using California as a case study, it explores reimbursement by cost category and a standard medical loss ratio (MLR) as potential policy options to improve nursing facility financial accountability and care quality.

  • Filling In The Long-Term Care Gaps

    Event Date:
    Event

    At a June 3 hearing of the Senate Special Committee on Aging, Diane Rowland, Executive Vice President of the Kaiser Family Foundation and Executive Director on the Kaiser Commission on Medicaid and the Uninsured, testified on the key challenges to providing a larger role for private long-term care insurance in financing long-term care for the elderly and people with disabilities. Her testimony coincided with the release of a policy brief on long-term care financing by…

  • Distribution of Medicaid Beneficiaries Who Use Long-Term Services and Supports, by Dual Eligibility Status, FY 2010

    Feature

    Distribution of Medicaid Beneficiaries Who Use Long-Term Services and Supports, by Dual Eligibility Status, FY 2010 Download Source KCMU and Urban Institute estimates based on FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 data. Because 2010 data were unavailable, 2009 MSIS data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

  • Long-Term Care Costs Can Exceed Seniors’ Income

    Feature

    Long-Term Care Costs Can Exceed Seniors’ Income Download Source MetLife Mature Market Institute. The 2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs, November 2012, available at: https://www.metlife.com/mmi/research/2012-market-survey-long-term-care-costs.html#keyfindings; U.S. Census Bureau, Current Population Survey, 2012 Annual Social and Economic Supplement, Table POV01.

  • Medicaid Acute and Long-Term Services and Supports Spending Per Enrollee, by Beneficiary Population, FY 2010

    Feature

    Medicaid Acute and Long-Term Services and Supports Spending Per Enrollee, by Beneficiary Population, FY 2010 Download Source KCMU and Urban Institute estimates based on data from FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 reports. Because 2010 data were unavailable, 2009 MSIS data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.