This paper, prepared for the National Governors Association, discusses the progress states have made in moving away from institutional care for Long-Term Supports and Services and toward home and community-based programs. It analyzes the opportunities available through the Affordable Care Act and other programs whereby states can continue that progress even in a challenging budget environment.
Director of Long-Term Services and Supports Policy and Research Cynthia H. Woodcock presented at the 27th National Home and Community-Based Services Conference in Washington, DC. This presentation provides an overview of the pilot program and data collection; describes profiles of care managers, care recipients, and caregivers; and discusses the project’s status and the next steps of the evaluation.
Senior Policy Analyst Ian Stockwell, MA, in conjunction with staff from the Maryland Department of Aging and the Maryland Department of Health and Mental Hygiene, presented at the 27th National Home and Community-Based Services (HCBS) Conference. This presentation discussed HCBS beginnings and momentum, including advocacy and costs, HCBS waivers, Aging and Disability Resource Centers (ADRCs), and Money Follows the Person (MFP); data and metrics to build community-based services; and using metrics to move forward. Stockwell focused on Hilltop’s research on utilization and expenditures of both institutional services and HCBS in Maryland, as well as on the Quality of Life Survey Hilltop conducted, to discuss how metrics were used and how they can be used going forward.
The Hilltop Institute conducted a literature review on pathways to Medicare-Medicaid eligibility at the request of the Medicare-Medicaid Coordination Office (MMCO) within the Centers for Medicare and Medicaid Services (CMS). This work was performed under Task Order RTOP CMS-10-022 awarded to Thomson Reuters (Healthcare), Inc., in 2010.Hilltop also prepared New Medicare-Medicaid Enrollees in Maryland: Demographic and Programmatic Characteristics and New Medicare-Medicaid Enrollees in Maryland: Prior Medicare and Medicaid Resource Use.
This report, which was presented at the Long-Term Care Interest Group Colloquium at the June 2011 AcademyHealth Annual Research Meeting in Seattle, Washington, discusses progress in rebalancing Medicaid long-term services and supports (LTSS) spending, how the Affordable Care Act can support states’ continued efforts to rebalance LTSS, and opportunities for future research to support continued system transformation.To access the presentation on this topic, click here.
At the AcademyHealth Annual Research Meeting (ARM), Hilltop Director of Long-Term Services and Supports Cynthia H. Woodcock, MBA, and Maryland Department of Health and Mental Hygiene Deputy Secretary of Finance and former Hilltop Executive Director Charles J. Milligan, Jr., JD, MPH, presented this keynote address at the Long-Term Care Colloquium. Woodcock and Milligan presented highlights from their invited paper focusing on the success, to date, of rebalancing long-term care toward community settings and the implications of provisions in the Affordable Care Act for future rebalancing efforts.To access the invited paper, click here.
At the AcademyHealth Annual Research Meeting (ARM), Hilltop Senior Policy Analyst Karen E. Johnson, MS, gave this poster presentation, which was also authored by Hilltop Director of Special Research and Development Anthony M. Tucker, PhD, and UMBC Assistant Professor Yi Huang, PhD. The poster described the use of a propensity score matching methodology to identify comparison groups among Medicare-Medicaid beneficiaries who received Medicaid-paid long-term services and supports (LTSS) via home and community-based (HCBS) waivers versus those who did not receive LTSS. This matching technique was used to establish comparable treatment/control pairs for subsequent analysis of cross-payer effects of providing Medicaid-paid LTSS on Medicare acute care resource use, and could be used more generally to strengthen policy analyses that are based on observational and/or administrative data.
Many of the opportunities made available by the Affordable Care Act (ACA) can be leveraged to work together and to build on existing initiatives. The result can be a strengthened infrastructure for service provision and a long-term services and supports (LTSS) system that can better meet the needs of Medicaid beneficiaries. This National Association of States United for Aging and Disabilities (NASUAD) issue brief, written by Hilltop Director of LTSS Policy and Research Cynthia H. Woodcock, MBA, summarizes key provisions of the ACA and considerations for states seeking to take advantage of these new opportunities.
Charles Milligan gave a presentation on opportunities to better serve dual eligiles to the Ohio Association of Health Plans and the Ohio Association of Area Agencies on Aging (O4A). He discussed the importance of integrating long-term services and supports for this population; the results of Hilltop’s research on Medicare/Medicaid cross-payer effects for dual eligibles that found that Medicare and Medicaid financing do not align to promote home and community-based services (HCBS) and that the HCBS waiver is only cost-effective (at the individual level) for Medicaid when it truly avoids a nursing home placement; and new opportunities for states under the Affordable Care Act to better serve dual eligibles.
This presentation, delivered by Charles Milligan to the Medicaid and CHIP Payment and Access Commission (MACPAC) in Washington, D.C., addressed the issue of coordinating long-term care for persons eligible for both Medicare and Medicaid (dual eligibles). Milligan discussed Hilltop’s research on Medicare/Medicaid cross-payer effects that found that Medicare and Medicaid financing do not align to promote home and community-based services.