Protecting Medicaid’s Promise

With the start of the new Congress and new Administration, health care policy is on the front burner in Washington. The future is very uncertain, and the stakes are high. Health care touches all of us and affects nearly 20% of the U.S. economy. AARP is very focused on making sure any health care reforms protect older Americans and their families, particularly from rising costs that push many to the brink. We are especially concerned about plans for Medicaid, which …

The Ban on Preexisting Condition Exclusions Helps Older Adults

Most Americans get their health insurance through their employer or through government-sponsored programs like Medicare or Medicaid. People who do not have access to those forms of coverage — for instance, because they are between jobs or are self-employed — typically buy health insurance directly from private insurers on the individual market. Since 2014, the Affordable Care Act (ACA) has provided a critical protection for individuals who seek insurance in this market: It bans insurance companies from considering people’s health …

Nursing Facility Transitions: A Cornerstone for Balancing Long-Term Services and Supports

When Abbie was first admitted to a nursing facility in Henderson, Nev., in December 2012, she was told she would probably be there for the rest of her life. For Abbie, who was 76 at the time, that was not an option. “That place was not my cup of tea,” she said. “I didn’t belong there.” About 1.5 million Americans currently live in a nursing facility. Like Abbie, whose story was told first by Nevada’s Money Follows the Person (MFP) …

Consumer Voices Matter: Meaningful Engagement of Consumers and Caregivers in Long-Term Care

Patient-centered care is responsive to the needs and values of the individuals receiving care, and is one aspect of a high-performing, high-quality health care system. The Centers for Medicare & Medicaid Services (CMS) recently issued a final rule that gives Medicaid managed care consumers and their family caregivers a seat at the table by requiring states to include consumer and family caregiver perspectives in the design, implementation and oversight of state-managed long-term services and supports (LTSS) programs. States should view the new …

Are We There Yet? Efforts to Balance Long-Term Services and Supports

“Marvin L. Dawkins was a 53-year-old AT&T manager when a blocked blood vessel left him paralyzed. It took 11 years, one lawsuit, repeated tangles over Medicaid rules — and a chance meeting on a church van — before he could extract himself from a nursing home outside Baltimore. Now he lives in an apartment with the assistance of an aide, gets out for a job that he says gives him purpose, socializes with new friends and old ones, and revels …

Building Capacity to Provide Behavioral Health Services to Dual Eligibles

The Centers for Medicare & Medicaid Services (CMS) launched the Financial Alignment Initiative (the Initiative) to improve the quality of care received by low-income adults who are eligible for Medicare and Medicaid — known as dual eligibles. Many of these individuals have unmet behavioral health needs, ranging from mild depression to serious mental illness, like schizophrenia and bipolar disorder. A recent update on the Initiative presented to the Medicare Payment Advisory Commission highlighted four challenges to providing behavioral health services …