Long Term Services and Supports

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Potential Changes to Medicaid Long-Term Care Spousal Impoverishment Rules: States’ Plans and Implications for Community Integration

On Thursday, November 15, 2018, the Kaiser Family Foundation (KFF) published an issue brief exploring the upcoming changes to spousal impoverishment policies in Federal Medicaid HCBS policy. This report provides an explanation of why spousal impoverishment policies exist, the changes made by the Affordable Care Act (ACA), and the potential implications of the expiration of these ACA changes.

Short URL: http://www.nasuad.org/node/70901

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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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Medicaid Home and Community-Based Services: Selected States' Program Structures and Challenges Providing Services

State Medicaid programs are increasingly opting to cover home and community-based services. This report looks at the efforts of various state Medicaid programs, examines their structure, and highlights the challenges encountered. From this review, GAO highlights three main challenges: 1) difficulty recruiting and retaining home care workers, 2) difficulty serving those with complex needs and, 3) limited funding for HCBS services.

Short URL: http://www.nasuad.org/node/70785

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Achieving Value in Medicaid Home- and Community-Based Care: Considerations for Managed Long-Term Services and Supports Programs

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide outlines considerations for adopting value-based payment (VBP) to promote high-quality MLTSS programs. It combines insights from five states - Minnesota, New York, Tennessee, Texas, and Virginia - with input from national health policy experts.

Short URL: http://www.nasuad.org/node/70745

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Managed Long-Term Services and Supports: Status of State Adoption and Areas of Program Evolution

This chapter is part of MACPAC's June 2018 Report to Congress on Medicaid and CHIP. It reports on the trend of states using managed long-term services and supports (MLTSS). The chapter discusses program outcomes, the added complexity of long-term services and supports in Medicaid managed care, and different directions being explored in MLTSS. It also identifies issues for further examination.

Short URL: http://www.nasuad.org/node/70555

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Do Managed Care Programs Covering Long-Term Services and Supports Reduce Waiting Lists for Home and Community-Based Services?

This paper examines whether there is evidence that MLTSS programs increase access to home and community-based services (HCBS). One theory states that MLTSS programs may reduce costs associated with the use of institutional services, thereby allowing states to expand HCBS services and reduce waiting lists. This brief uses this theory and examines changes in a state's HCBS waiting list as one way to measure access to HCBS.

Short URL: http://www.nasuad.org/node/70487

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