Long-Term Care: Where Are We and What’s Next?

This webinar will orient audience members to the current landscape of the long-term care delivery system, its funding mechanisms, and the state and federal legislation that model this system. Panelists will discuss and offer insights about potential solutions to create an accessible and financially sustainable long-term care system.

Our 2018 Speakers

Healthy Aging and Immunizations

This purpose of this briefing was to review the value of immunizations for aging adults, highlight factors that impact access to immunizations, and provide a review of coverage for adult vaccines under public and private insurance.

Chronic Pain & Opioid Addiction: The Role of Integrated Care

The opioid addiction crisis has thrown a spotlight on the physical and behavioral health issues surrounding chronic pain. This briefing examined innovative non-pharmacologic models to address chronic pain, including among the military and veteran population and through state Medicaid and safety net programs.

High-Need, High-Cost Patients: Challenges & Promising Models

Health systems have applied many innovative new strategies for improving quality and reducing costs when it comes to care for high-need, high-cost patients, who typically have multiple chronic conditions. Which of these innovations show promise, and what can we learn from them?

High-Need, High-Cost Patients: The Role of Behavioral Health

Behavioral health conditions, including mental health issues and substance use disorders, affect nearly one in five Americans and account for $57 billion in health care costs annually. This briefing discussed current initiatives to integrate behavioral and physical health care services in order to improve quality of care and reduce overall health care costs.

Home and Community-Based Services: System-wide Coordination to Improve Care, Hold Down Costs

The movement toward home and community-based, long-term services and supports (LTSS) continues to grow, resulting in increased demand for these services. The goal is to help people live in the community independently, yet many barriers to offering HCBS still exist. This briefing will examine the potential of HCBS to reduce health care costs and improve quality of care. It will explore the intersection of HCBS, the broader health care delivery system and Medicaid, which is the largest payer of LTSS.

Long-Term Services and Supports Toolkit: Changes and Challenges in Financing and Delivery

The aging of the baby boomers and the increase in the number of old-old persons (those 85 and older) are predictors for the increasing need for long-term services and supports (LTSS). Among persons age 65 and over, an estimated 70 percent will use LTSS. A new Alliance for Health Reform toolkit, “Long-Term Services and Supports: Changes and Challenges in Financing and Delivery,” provides a background on LTSS and discusses policy issues surrounding the topic.

Chronic Care Management: Is Medicare Advantage Leading the Way?

Efforts are underway throughout the Medicare program to better manage beneficiaries’ chronic conditions, with the goal of improving quality and lowering the costs of care. With an estimated 31 million Medicare beneficiaries suffering from a chronic condition such as cardiovascular disorders, diabetes and cancer, many still do not receive the coordinated services they need to manage their chronic conditions, and beneficiaries with multiple chronic conditions incur higher-than-average spending. However, traditional fee-for-service Medicare, Medicare Advantage, and newer models such as Accountable Care Organizations (ACOs) differ in the tools and methods available to manage chronic care.

Chronic Disease Prevention: Saving Lives, Saving Money

With a continued focus on the need to control the high and rising cost of care, Congress is looking for low cost, high yield policy solutions. Chronic illnesses are among the biggest drivers of growing health care costs, and a drain on worker productivity in our nation. For example, researchers note that per person health care spending for obese adults is 56 percent higher than for normal-weight adults. Diabetes and other chronic illnesses can be prevented or greatly delayed with solutions beyond or outside of medical care. Many fall into the category of health-related behaviors, such as whether we smoke, get exercise, eat a healthy diet– factors that are newly falling into the spheres of public health or population health.

Medicare-Medicaid Coordination for Dual Eligibles: What’s it All About?

Over nine million Americans receive benefits from both Medicare and Medicaid costing over $315 billion in health care services in the two programs combined. The dual eligibles account for 15 percent of the Medicaid population and almost 40 percent of all Medicaid expenditures for medical services; and 20 percent of the enrollees in Medicare, but 30 percent of the expenditures.

Health Care Workforce: Direct Care

In the move to increase access and coverage while enhancing the value of the health care dollar, the direct care workforce provides an important contribution to coordinated care in a high quality system. This toolkit, co-written by Bill Erwin and Deanna Okrent of the Alliance, aims to provide an array of resources and perspectives that describe numerous challenges to assuring an adequate workforce and some of the proposed solutions by the ACA. Supported by the Robert Wood Johnson Foundation.

Medicaid Managed Long-Term Services and Supports: Are More Caution and Oversight Needed?

Medicaid can be as much as 25 percent or more of a state’s expenditures — a share that appears to be rising, not shrinking. In 2011 Medicaid accounted for 24 percent of total state spending, including federal grants. To address their budgetary challenges, an increasing number of states are turning to Medicaid managed care. As of 2009, 47 percent of all Medicaid beneficiaries were enrolled in a managed care plan. Looking to save money in categories where the most is being spent, more states are starting to enroll older beneficiaries and those with disabilities in such plans, not just for acute care services, but for long-term services and supports (LTSS).

Health Care Costs: The Role of Technology and Chronic Conditions

This is the second event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. The series marks the Alliance for Health Reform’s 20th year of promoting informed and balanced discussion of health policy issues.