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FEATURED CASE STUDY

Needs of Medicare Beneficiaries with Mental Health Conditions

Needs of Medicare Beneficiaries with Mental Health Conditions

Our WorkNeeds of Medicare Beneficiaries with Mental Health Conditions THE ISSUE A third of Medicare beneficiaries experience a mental health condition. While providing access to high-quality behavioral health care is critical for meeting the needs of the growing...

State Strategies to Increase HCBS Provider Capacity

State Strategies to Increase HCBS Provider Capacity

Our WorkState Strategies to Increase HCBS Provider Capacity THE ISSUE Home- and community-based services (HCBS) allow people with significant physical and cognitive limitations, many of whom are dual eligible individuals, to live well and independently in the...

A Profile of Medicare-Medicaid Dual Beneficiaries

A Profile of Medicare-Medicaid Dual Beneficiaries

Our WorkA Profile of Medicare-Medicaid Dual Beneficiaries THE ISSUE The approximately 12 million “dual beneficiaries” enrolled in both Medicare and Medicaid comprise a medically, functionally, and socially complex population. These individuals are often forced to...

Profile of the California Medicare Population

Profile of the California Medicare Population

Our WorkProfile of the California Medicare Population THE ISSUE Understanding the characteristics of California’s growing Medicare population is important for the state and its stakeholders to understand the needs of these beneficiaries and identify opportunities to...

The Spectrum of State Models to Support Medicaid LTSS

The Spectrum of State Models to Support Medicaid LTSS

Our WorkThe Spectrum of State Models to Support Medicaid LTSS THE ISSUE Medicaid Long-Term Services and Supports (LTSS) are provided to only 6% of Medicaid beneficiaries but account for a disproportionate 33% of total Medicaid spend. In anticipation of demographic...

Access to Medicare-Medicaid Integrated Products

Access to Medicare-Medicaid Integrated Products

Our WorkAccess to Medicare-Medicaid Products THE ISSUE Dual eligible individuals represent a medically, socially, and often functionally complex population. They tend to be low-income with high-risk for socioeconomic disadvantage and use more healthcare services than...

Modernizing California’s HICAP: Strategy Recommendations

Modernizing California’s HICAP: Strategy Recommendations

Our WorkModernizing California's HICAP: Strategy Recommendations THE ISSUE State Health Insurance Assistance Programs (SHIPs) provide valuable counseling services to Medicare beneficiaries across the country. Each state program varies in its design and operations. The...

Role of Inpatient Rehabilitation Hospitals During the COVID-19 Pandemic

Role of Inpatient Rehabilitation Hospitals During the COVID-19 Pandemic

Our WorkRole of Inpatient Rehabilitation Hospitals During the COVID-19 Pandemic THE ISSUE Short-term acute care hospitals (STACHs), which typically discharge more than 40% of their Medicare FFS patients to post-acute care, have faced enormous pressures in managing not...

Advancing Non-Medical Supplemental Benefits in Medicare Advantage

Advancing Non-Medical Supplemental Benefits in Medicare Advantage

Our WorkAdvancing Non-Medical Supplemental Benefits in Medicare Advantage First available in 2019 and 2020, Medicare Advantage (MA) non-medical supplemental benefits provide an unprecedented opportunity to deliver valuable non-medical services to Medicare...

Role of LTAC Hospitals in COVID-19 Pandemic

Role of LTAC Hospitals in COVID-19 Pandemic

Our WorkRole of LTAC Hospitals in COVID-19 Pandemic THE ISSUE The ongoing COVID-19 pandemic has significantly disrupted all acute and post-acute care delivery in a manner that may permanently change hospital discharge patterns and provider roles moving forward....

Special Supplemental Benefits for the Chronically Ill in Plan Year 2021

Special Supplemental Benefits for the Chronically Ill in Plan Year 2021

Our WorkSpecial Supplemental Benefits for the Chronically Ill in Plan Year 2021 THE ISSUE Congress recently introduced new flexibility to allow plans to offer expanded supplemental benefits for chronically ill beneficiaries, known as Special Supplemental Benefits for...

Significant Financial Benefits Locked in LTCi Policies In Force Today

Significant Financial Benefits Locked in LTCi Policies In Force Today

Our WorkSignificant Financial Benefits Locked in LTCi Policies In Force Today Why State Support for the Long-Term Care Insurance Industry Makes Good Financial Sense THE ISSUE Our nation’s long-term care system relies heavily on personal savings and Medicaid to fund...

Medicare Beneficiaries Who Are Most Unlikely to Get a Flu Shot

Medicare Beneficiaries Who Are Most Unlikely to Get a Flu Shot

Our WorkMedicare Beneficiaries Who Are Most Unlikely to Get a Flu Shot THE ISSUE As the pandemic continues and routine healthcare utilization declines, many older adults are forgoing critical, preventive services. One of the most important preventive services...

Meeting Medicare Beneficiary Needs During COVID-19

Meeting Medicare Beneficiary Needs During COVID-19

Our WorkMeeting medicare beneficiary needs during covid-19 Using Medicare Advantage supplemental benefits to respond to the pandemic THE ISSUE The COVID-19 pandemic is placing an extraordinary toll on the healthcare system and restricting Medicare beneficiaries to...

An Idea That’s Growing

An Idea That’s Growing

Our WorkAn Idea That's Growing Long-Term Care Providers Taking Charge in Managed Care THE ISSUE While traditional insurance companies sponsor most Medicare Advantage (MA) plans, a growing number of hospitals, health systems, and physician groups also offer this...

POST-ACUTE PREPAREDNESS IN A COVID-19 WORLD

POST-ACUTE PREPAREDNESS IN A COVID-19 WORLD

Our WorkPOST-ACUTE PREPAREDNESS IN A COVID-19 WORLD A FRAMEWORK FOR POST-ACUTE CARE RECOVERY AND REDESIGN THE ISSUE The supply of care provided after a hospital stay – commonly referred to as “post-acute care” – has also been disrupted by the pandemic. Under normal...

HEALTHCARE SERVICES IN SENIOR LIVING AND NURSING HOMES

HEALTHCARE SERVICES IN SENIOR LIVING AND NURSING HOMES

Our WorkHEALTHCARE SERVICES IN SENIOR LIVING AND NURSING HOMES THE CASE FOR INTEGRATION   THE ISSUE Residents of senior living and nursing home facilities have substantial health needs and use a great deal of high-cost healthcare services. At the same time, many...

A TURNING POINT IN MEDICARE POLICY

A TURNING POINT IN MEDICARE POLICY

Our WorkA Turning Point in Medicare Policy Guiding Principles for New Flexibility Under Special Supplemental Benefits for the Chronically Ill THE ISSUE The Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act, signed into law on...

INVENTION BORN OF NECESSITY: THE PROVIDER-LED MEDICARE ADVANTAGE PLAN

Our WorkINVENTION BORN OF NECESSITY: THE PROVIDER-LED MEDICARE ADVANTAGE PLAN EVALUATING AN ORGANIZATION’S ABILITY TO PROVIDE INSURANCE TO ITS RESIDENTS   THE ISSUE In today’s changing environment, post-acute and long-term care providers face big challenges—increasing...

COMPARING THE CHARACTERISTICS AND EXPERIENCES OF MEDICARE BENEFICIARIES

COMPARING THE CHARACTERISTICS AND EXPERIENCES OF MEDICARE BENEFICIARIES

Our WorkCOMPARING THE CHARACTERISTICS AND EXPERIENCES OF MEDICARE BENEFICIARIES ANALYZING DATA TO PREPARE FOR GROWING NUMBER OF HIGH-NEED MEDICARE BENEFICIARIES THE ISSUE Starting in 2020, the United States will experience extraordinary growth in the 75+ population....

THE HOT SPOT FOR MEDICARE SPENDING

THE HOT SPOT FOR MEDICARE SPENDING

Our WorkFUNCTIONAL IMPAIRMENT A KEY FACTOR IN HIGH MEDICAL SPENDING IDENTIFYING THE KEY SPENDING DRIVERS IN MEDICARE POPULATION THE ISSUE The discourse on major drivers of high medical spending for American seniors often focuses on the role of chronic conditions but...

BIPARTISAN CONSENSUS IN LONG-TERM CARE FINANCING

BIPARTISAN CONSENSUS IN LONG-TERM CARE FINANCING

Our WorkBIPARTISAN CONSENSUS IN LONG-TERM CARE FINANCING EMERGING CONSENSUS ON A CHALLENGING PUBLIC POLICY PROBLEM THE ISSUE Half of all Americans turning 65 today will one day find themselves needing a high level of help with basic daily activities, such as walking,...

KEY COMPONENTS FOR SUCCESSFUL LTSS INTEGRATION

KEY COMPONENTS FOR SUCCESSFUL LTSS INTEGRATION

Our WorkKEY COMPONENTS FOR SUCCESSFUL LTSS INTEGRATION DEVELOPING THE BUSINESS CASE FOR LTSS INTEGRATION THE ISSUE A small share of the population with the most complex care needs accounts for a large portion of all healthcare spending. Healthcare payment and delivery...

REDUCING HOSPITALIZATIONS BY INTEGRATING HEALTH AND HOUSING

REDUCING HOSPITALIZATIONS BY INTEGRATING HEALTH AND HOUSING

Our WorkREDUCING HOSPITALIZATIONS BY INTEGRATING HEALTH AND HOUSING QUANTIFYING THE VALUE OF HEALTHCARE INVESTMENTS BY SENIOR HOUSING OPERATORS THE ISSUE Over the next 15 years, 80 percent of the United States population will experience one or more chronic conditions,...

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