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Hilltop Releases Report on Rebalancing Medicaid LTSS Systems

The Hilltop Institute has just released a report entitled Rebalancing Long-Term Services and Supports: Progress to Date and a Research Agenda for the Future. AcademyHealth invited Hilltop to write the report for presentation at the Long-Term Care Interest Group Colloquium at the June 2011 AcademyHealth Annual Research Meeting in Seattle, Washington.

Research on consumer preferences and wellbeing—together with the 1999 Olmstead decision in which the Supreme Court upheld an individual’s right to receive services “in the most integrated setting appropriate”*—has motivated states to pursue “rebalancing” initiatives to move their long-term services and supports (LTSS) systems away from a dependency on institutional care and toward a system that embraces consumer choice and care in the home or community with the active engagement of the consumer’s family and local support network. The federal government’s most recent commitment to rebalancing is found in numerous provisions in the Affordable Care Act (ACA), where new authorities offer financial incentives to states to shift rebalancing efforts to the next level in order to continue to transform the LTSS system.

Hilltop researchers reviewed states’ progress to date in rebalancing Medicaid LTSS spending for both the population of older adults and persons with physical disabilities and the population of persons with intellectual/developmental disabilities, measured by the proportion of Medicaid expenditures for LTSS that was directed to institutional care versus home and community-based services.

This report discusses states’ progress in rebalancing their LTSS systems, how the ACA can support states’ continued efforts to rebalance LTSS, and opportunities for future research to support continued system transformation.

To read the report, click here. To view the presentation, click here.

 


* Smith, J. D. E., & Calandrio, S. P. (2001). Forward to fundamental alteration: Addressing ADA Title II integration lawsuits after Olmstead v. L.C. Harvard Journal of Law & Public Policy, 24(3), 695-769.

 

 

 

 

 

 

The Hilltop Institute at the University of Maryland, Baltimore County (UMBC) is a nationally recognized policy and research center dedicated to improving the health and wellbeing of vulnerable populations. Hilltop conducts research, analysis, and evaluations on behalf of government agencies, foundations, and nonprofit organizations at the national, state, and local levels.
 
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