Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Publications

10/29/2010

Bella, M., and Palmer, L. (2009). Supporting Integrated Care for Dual Eligibles: Policy Options. Baltimore, MD: Center for Health Care Strategies.

This policy brief addresses opportunities for integrating care for this high-cost, high-need population. The brief outlines the rationale for integrating care for dually eligible persons, reasons why integration has been slow to progress, and emerging vehicles to accelerate the adoption of fully integrated care models. A companion resource paper provides additional details on promising integrated care models and the challenges and opportunities for supporting integrated approaches.

Available at http://www.chcs.org/publications3960/publications_show.htm?doc_id=982564

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CMS (2009). Providing Long Term Services and Supports in a Managed Care Delivery System. Enrollment Authorities and Rate Setting Techniques: Strategies States May Employ to Offer Managed HCBS, CMS Review Processes and Quality Requirements.

CMS has developed a brief technical assistance paper that outlines the enrollment authorities that states may consider when designing managed HCBS programs, the CMS review and approval process for each, and rate setting techniques that may be useful. This resource is the product of a CMS central and regional workgroup with expertise in managed care and HCBS, which reflects the progressive efforts underway in a number of states.

Available at http://www.cms.hhs.gov/CommunityServices/Downloads/ManagedLTSS.pdf

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CMS State Medicaid Director Letter. May 20, 2010. Community Living Initiative.

This letter provides some basic information on the Patient Protection and Affordable Care Act, P.L. 111-148, enacted March 23, 2010, and the Health Care and Education Reconciliation Act of 2010, P.L. 111-152, enacted March 30, 2010, (together referred to as the Affordable Care Act), and includes a link to the online technical assistance guide entitled Long Term Services and Supports in a Managed Care Delivery System.

Available at http://www.cms.gov/smdl/downloads/SMD10008.pdf

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Saucier, P., Kasten, J., and Burwell, B. (2009). Federal Authority for Medicare Special Needs Plans and Their Relationship to State Medicaid Programs. Prepared by Thomson Reuters for the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy.

This brief, the first in a series of three, reviews the history and current status of the Federal Medicare Special Needs Plan authority, with particular attention to provisions of interest to state Medicaid programs.

Available at http://aspe.hhs.gov/daltcp/reports/2009/leghist.htm

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Saucier, P., Burwell, B., and Gerst, K. (2005). The Past, Present and Future of Managed Long-Term Care. Prepared by Thomson Reuters and the University of Southern Maine Muskie School for the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy.

The focus of this study is Medicaid-financed long-term care, though the discussion includes Medicare since most Medicaid long-term care beneficiaries are dually eligible. Thus the study includes both Medicaid-only programs and integrated programs that manage both Medicaid and Medicare benefits. The study focuses on older persons and persons with physical disabilities, and excludes programs that are primarily targeted to persons with developmental disabilities or serious and persistent mental illness.

Available at http://aspe.hhs.gov/daltcp/reports/mltc.htm#section1

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Saucier, P., and Fox-Grage, W. (2005). Medicaid Managed Long-Term Care. Washington, DC: AARP, Public Policy Institute.

This issue brief reviews the limited but important experience of states that had implemented Medicaid managed long-term care programs at the time of publication, identifies key policy issues, and assesses the likelihood of future growth in these programs.

Available at http://www.aarp.org/health/medicare-insurance/info-2005/ib79_mmltc.html

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