Federal-state health coverage for low-income Americans

This policy brief takes a closer look at how California has implemented federal flexibilities to ensure the state’s long-term services and supports (LTSS) system is responsive to the needs of older adults and people with disabilities during the COVID-19 pandemic.
The number of individuals age 65 and older across the nation is projected to double in the next 50 years, from over 45 million in 2015 to over 95 million in 2065. California's age 65 and older population stands at 4 million, which is projected to double to over 8 million by 2030. This brief offers a basic primer on long-term services and supports (LTSS) in California within a national context. LTSS, also known as long-term care (LTC), provides assistance to people with disabilities of all ages, including older adults who need help with daily activities.
Following on previous reports describing the population who uses Medi-Cal-funded long-term services and supports, 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.
In this paper, the National Committee for Quality Assurance (NCQA) discusses prior integration efforts; introduces a model for integrated entities and a framework for assessing and promoting quality of integrated care; and explores the challenges to implementing and achieving the goals of person-centered, integrated care for Medicare-Medicaid beneficiaries. They use the word “framework” to describe the key concepts underlying the structure and process measures; it can also be expanded to include the content of performance measures as companions to the structure and process measures.
The California Medicaid Research Institute (CAMRI) developed an integrated and longitudinal database containing Medi-Cal and Medicare claims and assessment data of LTSS recipients in California in 2008. CAMRI's integrated database provides a unique opportunity to look at characteristics and program spending across the entire care continuum for beneficiaries with LTSS needs within Medi-Cal and for dual eligibles across Medicare and Medi-Cal. This report focuses on LTSS use and spending in the eight duals demonstration counties.
The California Medicaid Research Institute (CAMRI) compiled a report that identifies Californians who receive home-and community-based support and what services they receive. The brief brings together available information spread across multiple state and federal data systems.
In this brief, the California Medicaid Research Institute documents its process to acquire and link all the data sources necessary to evaluate long-term care services utilization, costs, and outcomes in California. This provides useful information about how data currently flows in the state and how system transformation can be supported.