Research & Policy Library

Dual Demonstration Project: A Look at Beneficiary Protections

The duals coordinated care demonstration projects require a three-way contract between participating states, health plans, and the Center for Medicare and Medicaid Services (CMS).  Massachusetts was the first state to sign a three-way contract.  The National Senior Citizen’s Law Center report,  "Massachusetts Three-Way Contract:  A Summary of Beneficiary Protections," provides insight into the rights

Family Caregivers Will be in Short Supply

Family caregivers are a primary support allowing older adults to age in their homes.  With the aging of the baby boom population, the demand for caregivers will increase.  According to the AARP report, "The Aging of the Baby Boom and the Growing Care Gap:  A Look at Future Declines in the Availability of Family Caregivers," the ratio of potential caregivers per frail older adult will decline from seven to four by 2030.  The report reminds us, yet again, of the need to develop a person-centered long-term services and supports system that can meet the needs of older adults in the future.

Overview of California’s Long-Term Care System

The use of long-term care services has increased, and will continue to as California’s population continues to age.  The California Health Care Foundation report, "Long Term Care in California:  Ready for Tomorrow’s Seniors?" examines the utilization, quality, and cost of the long-term care system in California. 

Consumer Choice and Continuity of Care in Managed LTSS

As more states transition Medicaid long-term services and supports (LTSS) to a managed care model, growing attention is being placed on consumer protections.  AARP published a report, "Consumer Choices and Continuity of Care in Managed Long-Term Services and Supports:  Emerging Practices and Lessons," identifying strong consumer education strategies as paramount to increased consumer involvement and meaningful choice.  While consumers did not experience significant interruptions in services during the transition period to managed LTSS, continued monitoring will be required for long-range impact on choice and continuity of care as plans gain more flexibility in managing their networks.

Building the Case for Research on End-of-Life Care

End-of-life and palliative care can be highly emotional with diverse needs and values guiding decisions.  The National Institute of Nursing Research report, "Building Momentum:  The Science of End-of-Life and Palliative Care," summarizes past research and identifies areas for further exploration.  While many of the issues may not have changed over the years, increased knowledge can guide development of a system that ensures quality, person centered end-of-life care.

Medicare Spending and Beneficiary Demographic Data

The MedPAC Data Book provides information on national health care and Medicare using tables and figures with brief discussions.  Information covered includes Medicare spending, Medicare beneficiary demographics, dual-eligible beneficiaries, quality of care in the Medicare program, and examination of provider settings.

Who Are the Dual Eligibles?

With impending changes to the health care delivery system for people dually eligible for Medicaid and Medicare, it is helpful to understand beneficiary experiences.  The Kaiser Family Foundation report, "Faces of Dually Eligible Beneficiaries:  Profiles of People with Medicare and Medicaid Coverage," brings the human side to the conversation.

Comparison of MOUs for Dual Eligible Financial Alignment Demonstrations

States have an opportunity to improve service delivery and share in cost savings with Medicare through the integrated care and financial alignment demonstrations for dual eligibles.  CMS has finalized memoranda of understanding (MOU) with five states, including California.  The Kaiser Commission on Medicaid and the Uninsured issue brief, "Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS," provides an overview of provisions in the five demonstrations.  Review of the MOUs provides insight into future systems changes and issues still needing to be addressed.

The State of Aging & Health in America 2013

According to the Center for Disease Control (CDC) report, "The State of Aging & Health in America 2013," the effects of chronic diseases on older adults will lead to an increased need for long-term services and supports over the next several decades.  The CDC report ranks all 50 states and the District of Columbia on 15 health indicators, providing information to help guide programs and policies to improve the health and well-being of older adults.

Rising Demand for Long-Term Services and Supports for Elderly People

If recent trends continue, there will be significant growth in the number of seniors over the age of 85 with functional and cognitive limitations requiring the use of long-term services and supports.  The Congressional Budget Office report, "Rising Demand for Long-Term Services and Supports for Elderly People," provides data and examines the financing of long-term services and supports, the functional and cognitive limitations of seniors in the community, where services are being provided, and possible scenarios for the future of long-term services and supports.

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