Medicaid blues: Hospitals, insurers wage political battle over managed-care dollars
Published: | 7:53 pm | Posted in: MLTC
“That’s all I have to say about that—I have to go bury the dead,” undertaker Stephen Holland said after listing his grievances with his state’s Medicaid politics early one Friday morning in June. Holland is one of a handful of white Democrats left in Mississippi’s House of Representatives, and he helped shape the past 20 […]
Managed Medicaid Long-Term Services and Supports is the Answer, But What is the Question?
Published: | 5:08 pm | Posted in: MLTC
A Presentation for the Annual Meeting of the Gerontological Society of America, November 2018: Medicaid expenditures (25%) continue to dominate state policy HCBS Waivers Have Grown Dramatically over the past two decades The expansion means that HCBS and Nursing Homes need to be managed States have been trying to shift risk– financial and management to […]
How Growing Inequality Is Altering The Long-Term Care Policy Battlefield, While Tightening The Financing Knot
Published: | 7:29 pm | Posted in: MLTC
For many years, long-term care (LTC) policy makers have tended to fall into two warring camps: those favoring expanded social insurance, and those wanting tighter Medicaid eligibility criteria to incentivize people to plan for and buy LTC insurance. Both sides have warned of looming financial catastrophe as the Baby Boomers move into retirement and more […]
Rhetoric and Reform in Waiver States
Published: | 5:06 pm | Posted in: MLTC
Abstract Seven states have used Section 1115 waivers to expand Medicaid as part of the Affordable Care Act (ACA). While each state pursued a unique plan, there are similarities in the types of changes each state desired to make. Equally important to how a state modified their Medicaid programs is how a state talked about […]
Minnesota Managed Care Longitudinal Data Analysis
Published: | 7:28 pm | Posted in: MLTC
EXECUTIVE SUMMARY This study tests the hypothesis that delivery of Medicare-funded and Medicaidfunded services to dually eligible beneficiaries aged 65 and older via fully integrated managed care plans is associated with stronger community-based service utilization patterns compared to service delivery when Medicare- and Medicaid-funded services are delivered independently. The hope is that integrated Medicare-Medicaid managed […]
Toward a Model Long-Term Services and Supports System: State Policy Elements
Published: | 4:20 pm | Posted in: MLTC
In response to a new Federal initiative to improve the U.S. long-term services and supports (LTSS) system, this commentary discusses an array of policies and practices that could potentially improve LTSS provision by shifting from institutional to community-based services, increasing equity across populations, offering consumers more choice and control, improving conditions for workers and caregivers, […]
Twenty-First Century Medicaid: The Final Managed Care Rule
Published: | 1:00 am | Posted in: MLTC
With enrollment reaching 74 percent of all beneficiaries, it is clear that managed care has become the standard organizing mechanism for a Medicaid program whose welfare roots are behind it and that now functions as a principal source of public insurance. Given this broad national policy direction, a strong yet flexible regulatory framework for Medicaid […]
Georgetown Report on Florida’s Long Term Care Medicaid Waiver
Published: | 2:12 pm | Posted in: MLTC
Florida’s 2011 Managed Care Legislation, HB 7107, established “Medicaid Managed Care,” a new statewide managed care program for all covered services. The program is expected to control Medicaid program costs by using a capitated rather than fee-for-service payment model. Two separate components are anticipated for the new program: the Florida Long-Term Care Managed Care program, slated […]
Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS
Published: | 8:40 pm | Posted in: MLTC
Using authority in the Affordable Care Act, the Centers for Medicare and Medicaid Services (CMS) has launcheddemonstrations that seek to improve care and control costs for people who are dually eligible for Medicare andMedicaid. Nearly 355,000 beneficiaries in nine states are enrolled in these demonstrations as of June, 2015. Implemented beginning in July 2013, the […]