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Written by: Michael Bolton on Monday, June 28, 2010 Posted in:

The Center for Health Care Strategies has recently published a policy brief educating states about their options for states to aid in their transition to from expensive institutional care to more affordable home- and community-based options.  This policy brief is a must read for those interesting in understanding the challenge of rebalancing care and exploring ways states can tackle this issue.

CHCS estimates that roughly two-thirds of Americans age 65 and older today will eventually need some type of long-term care — ranging from personal care assistance for managing daily activities at home to nursing home care — for an average of three years. Despite this reality, few people are insured for long-term care and few have adequate assets, with as many as two-thirds of the elderly unable to afford more than one year of nursing facility care. Consequently, Medicaid is the de facto payer of last resort for LTSS, picking up 40 percent of the nation’s long-term care costs.

According to the AARP Public Policy Institute, only five states (i.e., Alaska, California, New Mexico, Oregon, and Washington) currently spend more Medicaid LTSS dollars on home- and community-based services (HCBS) than nursing homes.

This policy brief provides states and federal policymakers with useful tools for understanding the current Medicaid long-term care environment; legal, regulatory, and bureaucratic barriers to rebalancing LTSS; promising solutions for rebalancing LTSS; and policy recommendations for improving the Medicaid LTSS system.

Additionally, to further help states explore and understand emerging options, CHCS is launching a new publications series: Innovations in the Medicaid Continuum of Care.  For more information, visit the Center for Health Care Strategies website: www.chcs.org.