Long Term and Chronic Care

Major Issues and Selected Initiatives Interest in managed care for older persons and persons with disabilities has intensified in recent years, as states and the federal government have searched for ways to make publicly funded programs more effective and less costly. The heightened interest has stimulated a lively debate among consumers, policy makers, advocates and […]

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  • Publications

    Reducing the Cost of Institutional Care: Downsizing, Diversion, Closing and Conversion of Nursing Homes

    Medicaid today pays for 41% of the nation’s long term care bill. Most of that spending (85%) is on institutions. As the Congress grapples with efforts to reduce Federal expenditures and balance the budget, the Medicaid program and its investment in long term care are particularly vulnerable to cuts. Indeed, Medicaid comprises nearly half of […]

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  • Publications

    The Arizona Long Term Care System

    Report 1 in a Series of State Case Studies Arizona began providing acute care services to Medicaid eligible residents in 1982 through the Arizona Health Care Cost Containment System (AHCCCS), a Section 1115 Research and Demonstraction Waiver demonstration program approved by the US Health Care Financing Administration (HCFA). Long term care services were covered under […]

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  • Publications

    Coordinating Services With and For Persons with Disabilities: A Challenge for State Government

    This paper reflects the conversations and considerations of a focus group of 18 individuals representing persons with disabilities and their advocates and State and Federal officials. Convened to review the National Academy for State Health Policy’s recent publication, A Guide to Federal Programs for People With Disabilities, the group was invited to muse about how […]

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  • Publications

    Setting Policy for Assisted Living: Key Issues

    This policy paper was prepared to assist state leaders in creating a viable, affordable, more user friendly alternative to nursing homes for a significant subset of the population who are now residing in or are likely in the future to enter a nursing facility if residential options are not available. To assist in preparing the […]

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    May 10, 2012 | Filed under: Long Term and Chronic Care, Publications

  • Publications

    State Long Term Care Programs At a Glance

    This report highlights What states have been doing to reduce their expenditures on long term care while maintaining access to needed services. In our analysis of the major strategies employed by the states we found that they fell into several categories: (1) Delivery system activities include strategies to reduce or control the number of nursing […]

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  • Publications

    How Are We Going to Pay for Long Term Care? Another Look at Long Term Care Insurance

    Although the debate over Medicare reform has had significant public exposure, the proposed cuts in Medicaid have received little attention. Yet these cuts could seriously impact the lives of millions of elderly citizens and their families. Medicare has done an admirable job of providing coverage for physician and hospital care, however, it does not provide […]

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    May 10, 2012 | Filed under: Long Term and Chronic Care, Medicaid, Publications

  • Publications

    State Eligibility Rules and Assessment Instruments: Implications for People with Alzheimer’s Disease

    The rising number of people with Alzheimer’s disease presents significant challenges for family members, caregivers, advocates, public policy makers and service providers. Faced with budgetary pressures and concerns about access to care and continuity of care, states are developing managed care programs for elderly Medicaid beneficiaries, reviewing eligibility policies and fine tuning assessment tools used […]

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  • Publications

    Managed Care for the Elderly: A Profile of Current Initiatives

    The purpose of this document is to summarize the current state-of-the-art in managed care for the elderly and to provide states with background information needed to launch their own initiatives to provide quality, cost effective care to the rapidly aging population. As you will see, attempts to truly coordinate primary, preventive, acute, and long term […]

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  • Publications

    Making Medicaid Work for the 21st Century: Improving Long-Term Services and Supports

    One of a series of issue briefs designed to share with federal and state policymakers, as well as other stakeholders, the issues and options raised by the Making Medicaid Work for the 21st Century workgroup. This brief discusses ways to improve long-term services and supports. mmw_longterm.pdf 196.5 KB

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