The Patient Protection and Affordable Care Act (ACA), signed into law on March 23, 2010, created landmark opportunities to transform our nation’s health care delivery system. Recognizing that health care and social issues impact a person’s health outcomes and wellbeing, key elements of the ACA sought to change the care delivery and LTSS landscape in an effort to help people access the right services and supports to meet their individualized needs.
The 2nd State Scorecard on Long-Term Services and Supports shows California ranked 9th overall. While California ranks higher than most states, much work remains to be done to improve affordability, quality, and coordination of services within the state’s system of care to ensure that older adults and people with disabilities can access needed services to support independence and quality of life.
The findings contained in this report demonstrate the inter-relationship between acute, postacute, and long-term services and support (LTSS) services for Medicare and Medicaid Enrollees (MMEs).
As states move to managed care delivery systems for individuals with complex needs, it is important to engage medical, behavioral health, and home- and community-based providers as well as hospitals and nursing facilities in establishing new programs. Providers can play an essential role by sharing successes and challenges with states and educating patients about the managed care program. This technical assistance brief offers tips to help states effectively engage providers in managed care program design and implementation.
The demand for long-term care will substantially outpace the rate of growth in the U.S. economy over the next decade. An estimated 12 million Americans are currently in need of long-term services and supports (LTSS)—defined as institutional or home-based assistance with activities of daily living such as bathing, dressing, or medication management—including both seniors and persons under age 65 living with physical or cognitive limitations. In the next two decades, the U.S. health care system will face a tidal wave of aging baby boomers. This, among many other factors, will create an unsustainable demand for LTSS in the coming years.
Behavioral health disorders are among the most prevalent and disabling chronic conditions affecting Medicare-Medicaid beneficiaries. These individuals have complex needs that require closely coordinated services, but misalignments between Medicare and Medicaid often result in fragmented, poor quality care. This brief describes early efforts in four states—Arizona, California, Massachusetts, and Washington—to improve integration of behavioral health services for Medicare-Medicaid beneficiaries.