During the COVID-19 public health emergency, states used Appendix K, a standalone appendix available during emergency situations, to modify their existing Medicaid HCBS 1915(c) waiver programs. Using Appendix K, states can make to make temporary changes to access and eligibility, payment, services, and other aspects of their waiver programs.
Long-Term Services & Supports (LTSS)
Reports
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Direct Care Worker Wages
September 1, 2023
Direct care workers (DCWs) such as nursing assistants, home health aides, and personal care assistants play an essential role in the health and well-being of over 20 million Americans. Yet DCW wages are not enough to make jobs competitive with entry level positions in other industries with similar job requirements which exacerbates the challenges in recruitment and retention of these workers.
ASPE Issue Brief
Caregivers and Long-Term Services and Supports
August 15, 2023
As the United States population ages, a larger proportion of individuals will likely need and use long-term services and supports (LTSS). Much of this support is provided by informal (i.e., unpaid) caregivers. For those that need paid LTSS, most Americans pay out-of-pocket. Some may do so until their personal resources are exhausted, and then rely on the Medicaid safety net.
ASPE Issue Brief
State Medicaid Telehealth Policies Before and During the COVID-19 Public Health Emergency: 2022 Update
November 22, 2022
This issue brief provides updates on state Medicaid policies regarding delivery of telehealth services by provider types and modalities, as of January 2022. The COVID-19 pandemic substantially accelerated interest in and utilization of telehealth across all payers including Medicaid.
ASPE Issue Brief
Resident and Facility Factors Associated with High Risk of Discharge from Nursing Facilities, 2012-2017: Issue Brief
September 29, 2022
This project tracked resident and facility factors associated with high risk of live discharges from nursing facilities.
Report
Resident and Facility Factors Associated with High Risk of Discharge from Nursing Facilities, 2012-2017: Final Report
September 29, 2022
This project tracked resident and facility factors associated with high risk of live discharges from nursing facilities.
ASPE Issue Brief, Report
High Risk of Discharge from Nursing Facilities
September 29, 2022
People can be discharged from nursing homes for many reasons. Discharges may be a positive outcome and at an individual’s choice. In other cases, discharges may be at the direction of the facility and against the will of the resident. There are strict rules about when involuntary facility-initiated discharges (FIDs) are allowed.
ASPE Issue Brief
State Use of Value-Based Payment in Nursing Facilities Issue Brief
September 6, 2022
Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment (VBP) programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume.
Report
Opioid Use in Long-Term Care Settings: Final Report
August 9, 2022
Opioid use was very common among the long-term care (LTC) residents in our sample. Perhaps reflecting their post-acute rehabilitative needs, discharged residents were more likely to have opioid use prior to LTC admission and at the beginning of the LTC stay.
ASPE Issue Brief
Federal Efforts to Address Racial and Ethnic Disparities in Alzheimer’s Disease and Related Dementias
June 7, 2022
The National Alzheimer’s Project Act (NAPA) requires “the inclusion of ethnic and racial populations at higher risk for Alzheimer's or least likely to receive care, in clinical, research, and service efforts with the purpose of decreasing health disparities in Alzheimer's”.1 In order to meet this requirement, in 2020 the Advisory Council on Alzheimer’s Research, Care, and Services recommended t