Long-Term Services & Supports (LTSS)

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.

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.

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.

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.

This project tracked resident and facility factors associated with high risk of live discharges from nursing facilities.

This project tracked resident and facility factors associated with high risk of live discharges from nursing facilities.

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.

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.

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.

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