Long-Term Care

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Collaborating to Address HCBS Workforce Challenges in MLTSS Programs

This report is the third in a series of publications from the MLTSS Institute. The report identifies the challenges and promising practices in addressing the mismatch between supply and demand for direct care workers in long term services and supports programs, all viewed through the lens of MLTSS programs. This report is co-authored by NASUAD and Sage Squirrel Consulting, LLC.

Short URL: http://www.nasuad.org/node/71262

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Strengthening Medicaid Long-Term Services and Supports in an Evolving Policy Environment: 2019 Update

This toolkit summarizes LTSS reform strategies adopted by state innovators. It identifies concrete policy strategies, operational steps, and federal and state authorities that states have used to advance LTSS reforms. It also includes specific case studies and advice for other states looking to implement similar reforms. In addition, CHCS has published a brief for state legislators looking for a summary of options for developing LTSS policies.

Short URL: http://www.nasuad.org/node/71239

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Home and Community-Based Services Beyond Medicaid: How StateFunded Programs Help Low-Income Adults with Care Needs Live at Home

This paper focuses on how state-funded home and community-based services programs can support low-income older adults. It highlights promising practices that support maximum independence for low-income older adults and/or people with physical disabilities and their family caregivers. The paper explores programs across nine states, including Washington state’s emerging innovation: the Medicaid Transformation demonstration.

Short URL: http://www.nasuad.org/node/71163

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The Financial Hardship Faced by Older Americans Needing Long-Term Services and Supports

This study analyzes the financial burden experienced by people who require long-term services and supports. The study analyzes medical and LTSS spending among older Medicare beneficiaries, particularly the costs of assistive devices and personal care. The results show that for medical services covered by Medicare, beneficiaries with a high need for long-term services spend more than $2,700 a year out of pocket on average, twice as high as those without such need.

Short URL: http://www.nasuad.org/node/71119

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Medicaid: What to Watch in 2019 from the Administration, Congress, and the States

This brief highlights the importance of ongoing litigation around the ACA and discusses Medicaid demonstration waiver activities. It also addresses the recent passage of bi-partisan legislation with new tools and financing that states can use to strengthen their response to the opioid crisis. Finally, the brief reviews issues including Medicaid financing for Puerto Rico and USVI; Medicaid and public charge changes; and reforms in benefits, payment and delivery systems.

Short URL: http://www.nasuad.org/node/71071

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Value-Based Payment in Medicaid Managed Long-Term Services and Supports: A Checklist for States

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide presents a checklist of four issues for consideration as states identify issues to consider when developing and adopting value-based payment (VBP) models for HCBS within managed long-term services and supports (MLTSS) programs. The guide also reviews strategies for stakeholder engagement.

Short URL: http://www.nasuad.org/node/71057

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States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019

This recently released report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019. The report focuses on changes in eligibility, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits, and pharmacy and opioid strategies.

Short URL: http://www.nasuad.org/node/70859

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A comparison of nursing home usage in states with and without Medicaid Managed LTSS

This study from Milliman highlights the success that MLTSS programs have had in reducing institutional care for older adults and people with disabilities compared to states operating a fee for service system, both in absolute numbers as well as the acuity level of consumers receiving services in nursing facilities.

Short URL: http://www.nasuad.org/node/70858

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HCBS Conference 2018- Presentations

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2018 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

Short URL: http://www.nasuad.org/node/70802

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