State budget woes and increased demand for community-based healthcare services are putting more pressure on states to implement Medicaid managed long-term services and supports.
Though the economic downturn continues to impact state budgets, a new report by AARP’s Public Policy Institute shows that more states are restructuring the way they deliver long-term services. Overall, many states are on the verge of transforming the way they finance and deliver publicly funded long-term services and supports, according to the report, “On the Verge: The Transformation of Long-Term Services and Supports.”
For example, 12 states have existing programs and another 11 have plans for implementing similar programs in 2012 or 2013. At least 28 states are focusing on improved integration of care for people who are considered dual eligibles – individuals who qualify for both the Medicare and Medicaid programs. Many states also used the economic downturn as an opportunity to balance services from institutional to noninstitutional settings, with 27 states reporting that home and community-based services increased from fiscal year 2010 to fiscal year 2011. In addition, 31 states reported that they expect to see increases in funding for those services from last year into this year.
“If implemented thoughtfully and with appropriate consumer protections and assurances that individuals will receive the services and supports they need, managed long-term services and supports has the potential to improve care through development of coordinated services, more efficient use of resources, and increased emphasis on preventive services and home and community-based care,” said ARP senior vice president Susan Reinhard in a statement.
Although fewer states made cuts to long-term services and supports in fiscal year 2011 compared to 2010, 14 states made cuts to non-Medicaid aging and disability services programs. Eleven states were expecting to cut these programs this year. While few states made cuts to Medicaid programs, a handful of states imposed restrictions to some Medicaid services, most notably personal care services like congregate meals, transportation and the Senior Community Service Employment Program.
The report noted several other trends, including a growing demand for publicly funded health services.
“Requests for services increase during an economic downturn because people have less income and assets and therefore qualify for government programs,” the report says.
States also continued to serve a greater number of Medicaid recipients with long-term services and supports needs in their homes or communities. Of 37 states that responded to the survey, 27 reported that home and community-based services census increased from fiscal 2010 to fiscal 2011, and 31 reported expected increases from 2011 to 2012.
Overall, 20 states reported that they expected the number of Medicaid nursing facility residents to decline while nine states expected the number the remain unchanged from fiscal 2010 to 2011. Only seven states expected the number of nursing home residents to increase.
Jenna Walls, a senior consultant with Health Management Associates, said in a statement that states are looking to improve quality in their Medicaid programs while at the same time drive down costs in a rough economic environment.
“State Medicaid programs have always been incubators of innovation, and it is clear from this survey that states are turning their efforts toward fundamentally changing the way healthcare is delivered for seniors and individuals with disabilities,” Walls said.
States were also able to preserve their non-Medicaid, state-only funded programs, which often serve people who do not qualify for Medicaid.
The recent healthcare reform law provides states with options to expand home and community-based services, although many states are reluctant to commit to some of these programs because of litigation pending before the U.S. Supreme Court, according to the report. States also are waiting for final federal implementation guidance.
Email
Print
Reprints/Licensing
Comment