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  • Case Study: Ohio’s Money Follows the Person Demonstration (HOME Choice)

    Issue Brief

    This case study of Ohio's Money Follows the Person demonstration, known as HOME Choice, describes key features of the program and highlights early program experiences. Ohio was one of 17 states to receive federal funding for the Money Follows the Person (MFP) rebalancing demonstration in January 2007. The state was awarded up to $100 million in enhanced federal matching funds in order to transition roughly 2,200 seniors and people with disabilities from institutions to home…

  • Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues

    Report

    Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues While private long-term care insurance (LTCI) has been available since the mid-1970s, its popularity has grown rapidly in recent years, and Congress is considering proposals that would further encourage LTCI purchase through expanded tax subsidies. Yet there has been little research on how well LTCI works and how much security it really provides. This report focuses on consumer protections for individuals buying LTCI in…

  • Key Facts: Women and Medicare

    Report

    Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities. Today, 22 million women one in five adult women rely on Medicare for basic health insurance protection. In fact, women comprise 57% of the Medicare population. Medicare helps to make health care more affordable for older women at a time in their lives when they are most likely 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…

  • Consumer Direction of Personal Assistance Services Programs in Medicaid: Insights from Enrollees in Four States

    Report

    Consumer Direction of Personal Assistance Services Programs in Medicaid: Insights from Enrollees in Four States Medicaid consumer direction of personal assistance services (CD-PAS) is a growing trend. Although overall enrollment in these programs is small, 42 states offered consumer direction in Medicaid in 2006. These programs allow Medicaid beneficiaries control over hiring, scheduling, training and paying of personal care attendants. This report is based focus groups with enrollees in CD-PAS programs in the four states…

  • 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…

  • Medicaid’s Long-Term Care Users: Spending Patterns Across Institutional and Community-based Settings

    Issue Brief

    The nation's primary payer for long-term services and supports, Medicaid finances 43 percent of all spending on long-term care services and covers a range of services and supports, including those needed by people to live independently in the community, as well as services provided in institutions. This report provides an overview of long-term care users and their acute and long-term care service spending. The report finds that although the individuals who rely on long-term care…

  • 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…