As states continue to implement various aspects of the Affordable Care Act (ACA), developing and expanding home and community-based alternatives to institutional care remains a priority for many state Medicaid programs.
Reports & Publications
Over the past several years, the State of Illinois has been implementing and planning several programs to move Medicaid and Medicare recipients into systems of care coordination. The original, mandatory Medicaid managed care program (MMC) in Illinois is known as the Integrated Care Program (ICP) and began on May 1, 2011 with the goal of improving the quality of care and services that the Medicaid population receives, along with saving the State money on Medicaid expenditures (estimated at $200 million over the first 5 years).
Researchers, policy experts, and advocates participating in an invitational conference discussed research needed to address pressing policy issues in long-term services and supports (LTSS). Future research on need for LTSS should focus on projections of need, geographic variations, equity, and unmet needs of consumers and caregivers. Research on access to home- and community-based services (HCBS) should address progress in rebalancing LTSS in favor of HCBS, cost-containment strategies, the shift to managed LTSS, and the performance of managed care organizations.
Provides a state-by-state look at trends in wages for personal care aides, a key job title within the direct-care workforce. Prepared as a resource guide on wages for advocates and policymakers concerned with the direct-care workforce, the chart book underscores the problem of poverty-level wages for PCAs, a factor that contributes to workforce instability for this high-demand workforce. The report finds that the national median wage for PCAs was $9.67 an hour in 2013 -- which is five percent lower than the median inflation-adjusted wage in 2003.
State Medicaid programs have expanded home and community-based services (HCBS). This article compares trends and variations in state policies for Medicaid HCBS programs in 2005 and 2010. State limitations on financial eligibility criteria and service benefits have remained stable. Although the use of consumer direction, independent providers, and family care providers has increased, some states do not have these options. The increased adoption of state cost control policies have led to large increases in persons on waiver wait lists.