The SCAN Foundation

More than a million people receiving long-term services and supports are “dual eligibles” enrolled in Medicare because they are over 65 and in Medicaid because they are poor. The “dual eligibles” have been found to have higher than average medical expenses, according to chapter five in the June 2010 report, “Report to the Congress: Aligning Incentives in Medicare," by the Medicare Payment Advisory Commission.

Keeping people from going back to the hospital is better for their physical and mental health and their ability to keep living at home. Repeated readmissions will weaken them so they will need long-term services and supports, often in a nursing home, according to a spring 2010 report, “Readmissions to California Hospitals, 2005 to 2006,” by the state of California Office of Statewide Health Planning and Development.

The cost of caring for people who receive long-term services and supports(LTSS) in nursing homes is a “ticking time bomb” threatening to explode state budgets, according to the June 21, 2010 report, “Medicaid Long-term Care: The Ticking Time Bomb,” by Deloitte Touche, the management consulting firm. “The convergence of an aging population, growing fiscal pressures and health care reform’s mandate for increased access to care will have far-reaching consequences for state-administered Medicaid long-term care (LTC) programs,” the study said.

The Affordable Care Act (ACA) creates a “Balancing Incentive Payment Program” for Medicaid, giving states extra money from the federal government, “if they commit to shifting more of their Medicaid Long-term Services and Supports spending toward non-institutional care,” according to the April 10, 2010 issue brief, “Medicaid Long-term Supports and Services Provisions in the Health Care Reform Law,” by the National Senior Citizens Law Center (NSCLC).