Commissioned & Supported Work

Innovative Approaches to Stratification and Rate Setting

Stratifying Medicare-Medicaid enrollees by their level of need may help states and health plans prioritize and promptly address the care management needs of these individuals in order to ensure high-quality, timely care. This new brief from the Center for Health Care Strategies describes how three states - California, Ohio, and Virginia - are accomplishing this work.

Defining the Business Case for Targeted Care Coordination

A new report and series of briefs from Avalere Health explores the use of non-medical data to better coordinate care for high risk Medicare beneficiaries, which can lead to improvements in care while providing health plans a return on investment.

CHCS INSIDE Strategies to Facilitate Managed Care Implementation

This brief focuses on key strategies used by Medicaid agencies in four states -- California, Florida, Massachusetts, and Texas - to facilitate managed care implementation. 

AP-NORC Releases New Analysis on Californians' Experiences with Long-Term Care

The Associated Press-NORC Center for Public Affairs Research released an issue brief with survey results on long-term care in California. The brief provides new data on how Californians are, or are not, planning for long-term care and their views on the roles of family and government. This analysis compares Californians to the rest of the country based on findings from a national poll released in May.

How California Can Ensure Continuity of Care for Vulnerable Seniors Transitioning to Managed Care

Giving low-income older adults in California a voice in their own care is critical to making a seamless transition into Cal MediConnect, a new managed care program, according to a new policy note by the UCLA Center for Health Policy Research.

California Medicaid Research Institute: Service Use and Expenditures Before and After Entry into California’s LTSS Programs

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). LTSS includes home and community based services (HCBS) as well as care delivered as a part of an extended stay in a nursing facility (NF). This research examined the patterns of health care related events and expenditures that preceded and followed the initiation of LTSS as well as the pattern of LTSS use following a hospitalization.

Center for Health Care Strategies - Engaging Providers in Building Managed Care Delivery Systems: Tips for States

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.

Bipartisan Policy Center - America’s Long-Term Care Crisis: Challenges in Financing and Delivery

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.

CHCS: State Approaches to Integrating Physical and Behavioral Health Services for Medicare-Medicaid Beneficiaries

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.

California Medicaid Research Institute: California County Profiles of Medi-Cal Beneficiaries Who Use Long-Term Services and Supports in 2008

Following on previous reports describing the population who uses Medi-Cal-funded long-term services and supports (LTSS), the California Medicaid Research Institute has produced a report that describes key characteristics of the population using LTSS across each of the state’s 58 counties.  This report describes spending and service use patterns across the 58 counties.  County-specific data files that accompany this report can be found by clicking here.