Commissioned & Supported Work
Posted January 7, 2013
At 18 percent of America’s economy and growing 2 percent faster than Gross Domestic Product, both the level and rate of growth of national health care spending are seen as alarming. While this isn’t a new problem, the amount of spending on health care, combined with the country’s fiscal challenges, makes the need to contain health care costs a national priority requiring a sense of urgency. High health care spending is exacerbating the government’s strained fiscal situation and is hurting the standard of living for many Americans.
Posted December 11, 2012
State Medicaid programs have made great strides in rebalancing the provision of long-term services and supports (LTSS) from institutional settings to home- and community-based care. Increasing consumer demand for community-based options and the need to ensure optimal cost-effectiveness of publicly-financed care have driven this transformation of Medicaid LTSS delivery systems. States are pursuing opportunities made available in the Affordable Care Act (ACA) to expand the availability of home- and community-based services (HCBS) to Medicaid beneficiaries.
Posted December 5, 2012
In an attempt to slow down growth in health care spending, state and federal governments have implemented a number of cost-containment strategies in recent years. Medicaid and Medicare expenditures are major contributors to the long term fiscal challenges facing the public sector. Medicaid, financed by both federal and state governments, pays for acute, post-acute, and long term services and supports (LTSS) for low-income seniors and certain individuals with disabilities, among others.
Posted September 11, 2012
The states and the federal government recognize the increasing demand for providing long-term services and supports (LTSS) in the community to promote a higher quality of life for Medicaid beneficiaries in the setting of their choice. The Balancing Incentive Program was created by the Affordable Care Act (ACA) to support this goal. The program provides enhanced federal funding for home- and community-based LTSS to states that commit to prescribed structural changes and targets for community-based LTSS expenditures.
Posted August 21, 2012
Recent policy changes put in motion by the Affordable Care Act (ACA) are shifting health care payment incentives in order to hold providers accountable for quality and cost of care. The shift towards value-based reimbursement has produced a variety of new payment policies, demonstration programs, and newly created agencies tasked with improving care coordination and reducing costs.
Posted August 21, 2012
Successful business strategies are formulated by articulating the strengths of the organization with the opportunities presented to it by the external environment in which it operates. When changes occur in the business environment – such as those in the technological, economic, and policy arenas – new opportunities are created. Organizations that align their existing core competencies, develop others that are needed, and are willing to modify their strategies accordingly can not only sustain themselves, but can thrive in the midst of these shifts.
Posted June 6, 2012
Home and community-based services (HCBS) refer to a broad range of health and social services needed by people with limited capacity for self-care. They are intended to help recipients with disabilities remain either at home or in other community-based settings while maintaining or restoring an individual’s highest level of functioning and independence possible. HCBS are intended to delay, and sometimes even prevent, entry into high-cost nursing facilities and other institutional facilities.
Posted April 30, 2012
Most individuals prefer to receive long-term services and supports (LTSS) in their own homes and other community settings instead of nursing facilities. States, in turn, have strong financial incentives to provide Medicaid covered LTSS through home- and community-based services (HCBS) because on average per person, one year of HCBS is half the cost of a year in a nursing facility. However, less than half of Medicaid LTSS dollars nationally are spent on HCBS.
Posted April 16, 2012
States have long had processes in place to determine programmatic eligibility for state and federally-funded long-term services and supports (LTSS). These processes vary from state to state and included manual as well as automated assessments. A standardized automated assessment is a tool that is available on a computer (e.g., laptop or tablet) that is used to collect and document client information in a uniform and consistent manner during a face-to-face interview.
Posted February 13, 2012
Long-term care is rarely mentioned in political discussions of deficit reduction. But the financing that supports it is most definitely on the table. Medicaid, along with Medicare and Social Security, is an “entitlement” targeted for “cuts”, “swaps,” or “caps” in numerous deficit-reduction proposals, both Republican and Democratic. And Medicaid—most often characterized as the federal-state health insurance program for low and modest income people—is, in fact, the nation’s only safety net for people who need extensive long-term care services.