publication

Long-Term Care


Californians with Medicare and Medi-Cal have many choices to get the health coverage they need, but choices vary by county. This brief outlines available choices across the state and describes the My Care, My Choice web resource.
On June 27, 2019, California Governor Gavin Newsom signed California’s 2019-20 budget. The budget reflects new program investments for older adults and people with disabilities, including staff resources for the state’s Master Plan for Aging.
On May 9, 2019, California Governor Gavin Newsom released the May Revision of the 2019-20 budget. The revision includes modest program changes that impact services for older adults and people with disabilities, including staff resources for the state’s Master Plan for Aging.
The Blueprint for Health Plans (Executive Summary) highlights successful partnerships for delivering social services and helps identify future opportunities.
The integration of community-based organizations (CBOs) into health plan networks, on both a formal and informal basis, can help meet the needs of older adults with complex medical and social needs. The Blueprint for Health Plans (Full Report) highlights successful partnerships for delivering social services and helps identify future opportunities.
On January 10, 2019, Governor Gavin Newsom released the 2019-20 proposed budget. Learn which modest program changes would impact services for older adults and people with disabilities.
Drawing from four years of Cal MediConnect evaluation results, this brief highlights recommendations for policymakers and health plans to consider in improving integrated systems of care for people with Medicare and Medicaid.
On June 27, 2018, Governor Brown signed California’s 2018-2019 budget. In this fact sheet, read a summary of budget items impacting older adults and people with disabilities.
On May 11, 2018, California Governor Edmund G. Brown, Jr. released the May Revision of the 2018-2019 budget. While it includes a significant increase in revenues and modest program investments for older adults and people with disabilities, the state still has no overarching master strategy to meet the needs of an aging California. Read more in this fact sheet.
In this Perspectives, Dr. Chernof reviews what's missing from Governor Brown's proposed 2018-2019 budget. It outlined modest adjustments to programs impacting older adults and people with disabilities and focuses on building the financial stability of the state, paying off debt, and strengthening elements of our infrastructure. It fails, however, to outline solutions to the challenges facing California’s older adults and people with disabilities.
On January 10, 2018, California Governor Brown released the proposed 2018-2019 budget. In this fact sheet, learn what modest program changes impacting older adults and people with disabilities were included, and where the budget falls short.
Read the Foundation’s top 10 recommendations for improving integrated systems of care for people with Medicare and Medicaid, also known as dually eligible individuals.
California maintained its rank at No. 9, but it must do more to keep up with the growth of the older adult population. This brief highlights trends in California’s performance and opportunities to improve its rate of progress.
As California’s Medicare-Medicaid demonstration becomes more established, a clearer picture is emerging. Over the last 18 months, Field Research Corporation and the University of California have completed numerous evaluation activities to better understand the experiences of dual eligible individuals (both those who enrolled in Cal MediConnect and those who opted out), health plans, health systems, and community-based providers. In this Perspectives, Dr. Chernof examines this rich body of work, identifying successes and what needs to improve as the demonstration moves forward.
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.
In this Perspectives, Dr. Chernof highlights the similarities across each set of recommendations and advocates for the multi-pronged approach put forth by all groups—one that clarifies personal responsibility, outlines private market solutions, addresses long-term needs, and refocuses Medicaid’s role.
Last year, modeling efforts distilled various options to improve America’s financing system for long-term care. This month, three organizations – the Bipartisan Policy Center, LeadingAge, and the Long-Term Care Financing Collaborative – released related policy recommendations. This analysis identifies common themes and notes where the recommendations differ in perspective.
Coordinated care makes a difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings, and helps people thrive in their communities.  Read Karen's case study.
Coordinated care makes a difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings, and helps people thrive in their communities.  Read Zena's case study.
Coordinated Care Makes a Difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings and helps people thrive in their communities. Read Gabriela's case study.
Coordinated Care Makes a Difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings and helps people thrive in their communities. Read Josephine's case study.
Coordinated Care Makes a Difference.  It prevents avoidable hospital re-admissions, transitions people out of institutional settings and helps people thrive in their communities.  Read Chito's case study.
In this Perspectives, Dr. Chernof explains what recent polling results and coordinated care stories tell us about the experiences of Medicare-Medicaid individuals, and identifies opportunities to further strengthen and expand support.
This policy brief summarizes findings from long-term care financing option research by the Urban Institute and Milliman, Inc., courtesy of Health Affairs.
Greater costs for older women, who average 2-1/2 years of high-level need.
Half of U.S. reaching 65 will need high levels of costly help with daily activities.
1 in 7 of all older Americans will need a high level of help with everyday activities for 5+ years.
Families pay >50% of costs for high-level needs that older Americans face.
California is among a dozen states participating in the national demonstration to improve care for people with serious chronic illnesses and functional limitations who qualify for both Medicaid and Medicare. We commissioned the Field Research Corporation to poll the state's dual eligibles, including people enrolled and those opting out in five demonstration counties as well as people in non-demonstration counties. Find out more in this week's Perspectives.
Read Dr. Bruce Chernof's Perspectives exploring progress on eight areas from the Affordable Care Act to help older Americans get the right care at the right time by the right providers.
The California Senate Select Committee on Aging and Long-Term Care released a report with recommendations on how California can transform its long-term care system. Read Dr. Bruce Chernof's latest Perspectives on three of the report's recommendations state lawmakers should focus on in the new legislative session.
In this Perspectives, Dr. Chernof discusses California's ranking in the 2014 Long-Term Services and Supports (LTSS) State Scorecard. The LTSS State Scorecard is published by AARP Policy Institute every three years, with support from The Commonwealth Fund and The SCAN Foundation.
This policy brief describes California’s results in the 2014 Long-Term Services and Supports State Scorecard, identifying areas for improvement as well as policy opportunities to transform and improve the state’s system of care.
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.
This brief seeks to answer the question of how many employed individuals (who work for large companies, small companies, or are self-employed) do not currently have access to long-term care coverage. This brief also considers the characteristics that make different types of employers strong or weak prospects for long-term care planning options.
This brief series summarizes current issues in financing long-term care and outlines policy options for increasing affordable access to services.
This brief series summarizes current issues in financing long-term care and outlines policy options for increasing affordable access to services.
Many older adults pay for long-term care out of their income and personal savings until they are poor enough to qualify for Medicaid. In an effort to avoid exhausting their resources and relying on Medicaid, others depend on unpaid family support or go without needed services. Learn more in this policy brief, developed with Avalere.
This paper serves as an overview of the Shaping Affordable Pathways for Aging with Dignity series. The series summarizes current issues in financing long-term care and outlines policy options for increasing affordable access to services.
For people who have been independent all of their lives, transitioning to Medicaid means depending on a means-tested welfare program for their health and long-term care services. Moreover, people transitioning to Medicaid are a substantial portion of state Medicaid expenditures. In an effort to avoid exhausting their resources and relying on Medicaid, others depend on unpaid family support or go without needed services.
The long-term care financing series summarizes current issues in financing long-term care and outlines policy options for increasing affordable access to services.
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.
This is the third report coming from the California Medicaid Research Institute (CAMRI) project entitled: Comprehensive Analysis of Home- and Community-Based Services in California. The report describes Medicare and Medi-Cal spending for those beneficiaries using long-term services and supports funded by Medi-Cal.
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.
The SCAN Foundation, in partnership with Avalere Health, released a web-based modeling tool that enables policymakers and the public to test the budgetary implications of a wide variety of federally run long-term care insurance programs. The model, called the Long-Term Care Policy Simulator, produces more than 2,500 unique outputs, each illustrating how public long-term care insurance program designs and benefits translate into estimated coverage, participation rates, and costs to participants and taxpayers. Read more in this report.