Over the next two decades, analysts project that states will collectively spend nearly $1.6 trillion dollars for long-term care supports and services (LTSS) for elderly and disabled citizens and the federal government will contribute an additional $2.1 trillion, for a total of $3.7 trillion. Current estimates are that more than two-thirds of Americans age 65+ today will need long-term care with an average duration of need of about three years.* In response, states are seeking fresh approaches for delivering Medicaid-funded LTSS, with an emphasis on reducing costly institutional care through home- and community-based (HCBS) "aging in place" initiatives.
This report presents an array of innovative initiatives from across the nation offering alternatives for reforming the delivery of Medicaid-funded long-term care. It includes both innovations that have been implemented as well as promising practices for more effectively delivering community-based long-term supports and services. Innovations included cover:
This report is part of CHCS' Innovations in the Medicaid Continuum of Care series, developed to help state and federal policymakers identify high-quality and cost-effective strategies for addressing the full range of clinical and long-term supports and services (LTSS) needs of Medicaid beneficiaries.
* D.A. Shostak and P.A. London, PhD. "State Medicaid Expenditures for Long-Term Care, 2008-2027," America's Health Insurance Plans (September 2008).