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Improving the Financial Accountability of Nursing Facilities

This report examines nursing facility expenditures to assess relative spending increases in areas such as nursing services, administrative costs, and profits. Using California as a case study, it explores reimbursement by cost category and a standard medical loss ratio (MLR) as potential policy options to improve nursing facility financial accountability and care quality.

Overview of Nursing Facility Capacity, Financing, and Ownership in the United States in 2011

Introduction Nursing facilities are a major provider of long-term care services in the United States. These facilities provide medical, skilled nursing, and rehabilitative services on an inpatient basis to individuals who need assistance performing activities of daily living, such as bathing and dressing. Nursing facilities are one part of the…

The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession

This annual 50-state survey finds that number of people on Medicaid and state spending on the program are climbing sharply as a result of the recession, straining state budgets and pressuring officials to curb costs despite increased financial help from the federal government through the American Recovery and Reinvestment Act…

Nursing Home Reform: Then and Now

To mark the 20th anniversary of the passage of landmark federal legislation to improve the quality of nursing home care, the Omnibus Budget Reconciliation Act of 1987 (known as OBRA 87), this video examines the history surrounding the law. The video includes a look at the state of nursing home…

Medicaid Long-Term Services and Supports: Key Considerations for Successful Transitions from Fee-For-Service to Capitated Managed Care Programs

Although relatively few Medicaid beneficiaries are in capitated managed long-term services and supports (LTSS) programs, significant expansion is anticipated as more than half of states are implementing or proposing new programs that would include a transition from fee-for-service (FFS) to capitated managed care in the LTSS delivery system. By definition,…

Medicare’s Role for Older Women

This fact sheet, Medicare’s Role for Older Women, discusses the characteristics of female Medicare beneficiaries, their health care needs, the structure of Medicare including cost-sharing requirements, and anticipated changes due to health reform.

Money Follows the Person: A 2013 State Survey of Transitions, Services, and Costs

The Money Follows the Person (MFP) demonstration provides enhanced federal matching funds, allowing states to better support Medicaid long-term services and supports beneficiaries in transitioning from institutions back to the community. This report highlights 2013 MFP enrollment and spending trends and services and supports offered across state MFP demonstrations.

Tennessee’s Money Follows the Person Demonstration: Supporting Rebalancing in a Managed Long-Term Services and Supports Model

Tennessee’s Money Follows the Person (MFP) demonstration, implemented within the context of Tennessee’s pre-existing capitated Medicaid managed care delivery system, is an integral component of the state’s Medicaid long-term services and supports rebalancing efforts. This case study describes key features of Tennessee’s MFP demonstration and highlights recent program experiences.