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Financial Alignment Models for Dual Eligibles: An Update

The nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design…

Long-term Services and Supports: A Rebalancing Act

The ongoing debate over the federal budget and deficit reduction presents a balancing act for policymakers, as many compelling interests compete for scarce dollars. But for 10 million older adults and people with disabilities who need long-term services and supports, there is a “rebalancing act” in progress. The aim is…

Examining Medicaid Managed Long-Term Service and Support Programs: Key Issues To Consider

There is increased interest among states in operating Medicaid managed long-term services and support (MLTSS) programs rather than paying for long-term services and supports (LTSS) on a fee-for-service basis, as has been the general practice. This issue brief examines key issues for states to consider if they are contemplating a…

State Options That Expand Access to Medicaid Home and Community-Based Services

This background paper examines various aspects of the Medicaid program that can expand access to home and community-based services (HCBS) and rebalance long-term care spending in favor of HCBS. As a result of the long-standing requirement that states cover facility-based care, the majority of Medicaid long-term care (LTC) expenditures historically…

A Primer on Dually Eligible Beneficiaries

The nine million dually eligible beneficiaries are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of Medicare and Medicaid spending. Because they often have complex medical and long-term care needs, and must navigate both Medicaid and…

Medicaid Matters: Understanding Medicaid’s Role in Our Health Care System

This fact sheet provides key information about the Medicaid program and its role in our health care system and state economies. The nation’s public health insurance program for low-income people is counter-cyclical, expanding during the recent recession to assist millions of individuals and families affected by the loss of jobs…

Money Follows the Person: A 2010 Snapshot

Enacted into law in 2006 as part of the Deficit Reduction Act (DRA), the Money Follows the Person demonstration provides states with enhanced federal matching funds for twelve months for each Medicaid beneficiary transitioned from an institutional setting to a community-based setting. In July 2010, the Kaiser Commission on Medicaid and the Uninsured (KCMU) surveyed states about the current status of their MFP program including trends in enrollment, services and per capita spending.