Home and Community-Based Services: The Right Place and the Right Time

As evidenced at a recent hearing of the federal Commission on Long-Term Care, broad support is building: It’s time to end Medicaid’s “institutional bias.” It’s not rational that Medicaid entitles eligible individuals to be placed in nursing homes, while limiting their ability to receive services at home. On average, the Medicaid program can serve about three older people or adults with physical disabilities with home- and community-based services (HCBS) for the cost of putting one in a nursing home. Moreover, …

Transition to Medicaid Managed Long-Term Services and Supports: How Is It Going?

States are rapidly moving from fee-for-service to managed care for Medicaid long-term services and supports (LTSS). An inventory conducted for the federal government found that the number of states using Medicaid Managed LTSS grew from 8 in 2004 to 16 in 2012, and an AARP Public Policy Institute study  shows 11 states planning to develop new Medicaid Managed LTSS programs in 2013. Pros and Cons There are advantages as well as concerns about moving to capitated, risk-based managed care for Medicaid enrollees with LTSS needs. …

Do the Rich Benefit from Medicaid?

Do the rich benefit from the welfare-based Medicaid program? Not according to much of the testimony presented at a recent hearing of the federal Commission on Long-Term Care. Here are key questions the hearing addressed: Do wealthy people transfer or shelter assets in order to qualify for Medicaid? At the hearing, Ellen O’Brien, formerly from MACPAC, described the evidence from several major studies and concluded: “There is little basis for the assertion that people with substantial incomes or assets are …

New Health Care Coverage Gap

Meet Lorna, a 59-year-old who has been unemployed for a year and, as a result, doesn’t have health insurance. She has Type-2 Diabetes.  Recently she had to have some blood tests done, costing $600 that she can’t afford.  She has a broken tooth that she’s not able to get fixed.  She wants to work, but can’t find a job in the area. Meet a 60-year-old woman whose husband retired in 2010 and, as a result, she lost her health insurance coverage. The …

The Costs of Not Expanding Medicaid

I generally don’t like to tell people that I majored in economics in college, because – the painful truth be told – there’s not a lot that I actually remember about “the dismal science.” One of the few things I do remember, however, is the concept of “opportunity cost.” That’s the name economists give to the cost of not doing something. Which brings us, in today’s lesson, to Medicaid, the government-sponsored health insurance program for certain groups of low-income Americans. …

States Seize Opportunities to Improve Medicaid Long-Term Services and Supports

Increasing State Interest in Affordable Care Act Options that Impact LTSS Populations   A new study by the AARP Public Policy Institute finds that many states are moving to take advantage of new financial incentives to improve delivery of home- and community-based services (HCBS) to people who need long-term services and supports (LTSS). Medicaid, the largest source of public funding for LTSS, gives states many options for providing HCBS. While states are not required to provide HCBS, all states provide at …