Medicaid Waivers

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Medicaid Home and Community-Based Services Enrollment and Spending

This issue brief highlights Medicaid HCBS enrollment and spending data from the Kaiser Family Foundation's 17th annual state survey. The report found that nearly all Medicaid HCBS enrollment (86%) and spending (93%) went to services provided at state option. This optional nature of most HCBS covered populations and services puts individuals at risk of losing services if the current structure of Medicaid financing were to change.

Short URL: http://www.nasuad.org/node/71326

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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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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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Report for Washington Health Home Managed Fee-for-Service (MFFS): Final Demonstration Year 2 and Preliminary Demonstration Year 3 Medicare Savings Estimates

This report summarizes the Medicare Parts A & B actuarial savings analysis of the Washington managed fee-for-service (MFFS) demonstration for 2015 and 2016. The Washington Health Home MFFS demonstration aims to improve service quality and integration while reducing costs of care for high-risk, high-cost dually eligible beneficiaries. For 2015, Washington demonstrated a final gross Medicare savings of $30 million. The preliminary gross Medicare savings for 2016 are $42 million.

Short URL: http://www.nasuad.org/node/70922

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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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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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Managed Long-Term Services and Supports: Interim Evaluation Report

As part of Mathematica’s ongoing evaluation project of section 1115 demonstrations, they have released their interim findings on MLTSS programs. This preliminary report looked closely MLTSS programs in New York and Tennessee and found mixed results regarding the goals of reducing hospitalizations and rebalancing care. Mathematica aims to release a final report on the effectiveness of MLTSS in 2019.

Short URL: http://www.nasuad.org/node/70413

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Delivery System Reform Incentive Payments: Interim Evaluation Report

As part of Mathematica’s ongoing evaluation project of section 1115 demonstrations, they have released their interim findings on the DSRIP program. This report shows quantitative evidence of DSRIP motivating positive provider actions, but the program’s impact on outcomes is still unclear. Mathematica aims to release a final report on the effectiveness of DSRIP in 2019.

Short URL: http://www.nasuad.org/node/70412

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How Might Medicaid Adults with Disabilities Be Affected By Work Requirements in Section 1115 Waiver Programs?

This issue brief from the Kaiser Family Foundation examines the implications of work requirements for Medicaid recipients with disabilities. Kaiser’s analysis finds that waivers that condition Medicaid eligibility on meeting a work requirement could affect people with disabilities who have limitations that interfere with their ability to work but do not rise to the stringent SSI level of disability.

Short URL: http://www.nasuad.org/node/70128

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Medicaid and Work Requirements: New Guidance, State Waiver Details and Key Issues

This brief from the Kaiser Family Foundation describes what the Medicaid eligibility work requirements would be in each state, including what would count as work activities, the hours required, and what the common exemptions to the requirements would be. The brief also describes key issues to consider in implementing such requirements, such as administrative costs, potential confusion over documentation requirements and the risk that some people will lose coverage for which they remain eligible.

Short URL: http://www.nasuad.org/node/70090

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