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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 Eligibility for Individuals with Disabilities

    Issue Brief

    This issue paper updates the July 1999 report and provides a general overview of federal Medicaid eligibility policy for the low-income disabled population. This paper focuses on four broad groups of individuals with disabilities: children under 18; adults under 65 who are not living in institutions; adults under 65 who are living in institutions; and adults under 65 who are also eligible for Medicare. In addition, this paper includes the new eligibility options offered under…

  • Medicaid Financing: The Basics

    Issue Brief

    Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.

  • Medicaid’s Home Care Support for Family Caregivers in 2025

    Issue Brief

    Medicaid home care programs offer various supports to family caregivers such as paid caregiving, self-directed services, respite care, and caregiver training. This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

  • Payment Rates for Medicaid Home Care Ahead of the 2025 Reconciliation Law

    Issue Brief

    Increased payment rates for Medicaid home care workers are states’ key approach to addressing workforce shortages. This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

  • Profiles of Nursing Home Residents on Medicaid

    Report

    This report illustrates through case examples the experiences and challenges of low- and modest-income people who rely on Medicaid to pay for nursing home expenses. These case examples were developed through in-person interviews with nursing home residents and their families in three states: Georgia, Kansas and Virginia. The first section of the report summarizes the themes and issues shared across the interviews Kaiser conducted, while the second section presents the individual stories of a subset…

  • 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…