TY - JOUR
AU - L. A. M. Palmer
AU - G. Khatutsky
AU - E. Walsh
AU - M. Toth
AU - G. Boldt
AU - Z. Feng
AU - A. M. Greene
AU - G. Boyer
A1 - 
AB - The Centers for Medicare & Medicaid Services' Financial Alignment Initiative conducted its demonstration across multiple states to test the impact of integrating care and financing for medical, behavioral, and long-term services and supports (LTSS) for dually eligible Medicare-Medicaid beneficiaries. We analyzed the demonstration's impact on long-stay nursing facility (NF) use in eight states. All states implemented approaches to improve integration and reduce NF use but only five states favorably impacted long-stay NF utilization. Ohio, Washington, Texas, South Carolina, and Colorado had a 4.22, 3.50, 1.82, 1.46, and 1.30 percentage point decrease in the annual probability of long-stay NF use, respectively, relative to each state's comparison group. Effective approaches to integration included robust connections between health care systems and LTSS providers, leveraging existing state LTSS infrastructure, and utilizing Area Agencies on Aging for care coordination. Barriers to effective integration included complex waiver programs, service carve outs, and weak collaborative relationships.
AD - Aging, Disability and Long-Term Care, RTI International, Research Triangle Park, NC, USA. RINGGOLD: 6856; Health Coverage for Low-Income and Uninsured Populations, RTI International, Research Triangle Park, NC, USA. RINGGOLD: 6856; Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, Baltimore, MD, USA. RINGGOLD: 1498
AN - 41251128
BT - J Appl Gerontol
C5 - Healthcare Disparities
DA - Nov 18
DO - 10.1177/07334648251398601
DP - NLM
ET - 20251118
JF - J Appl Gerontol
LA - eng
N2 - The Centers for Medicare & Medicaid Services' Financial Alignment Initiative conducted its demonstration across multiple states to test the impact of integrating care and financing for medical, behavioral, and long-term services and supports (LTSS) for dually eligible Medicare-Medicaid beneficiaries. We analyzed the demonstration's impact on long-stay nursing facility (NF) use in eight states. All states implemented approaches to improve integration and reduce NF use but only five states favorably impacted long-stay NF utilization. Ohio, Washington, Texas, South Carolina, and Colorado had a 4.22, 3.50, 1.82, 1.46, and 1.30 percentage point decrease in the annual probability of long-stay NF use, respectively, relative to each state's comparison group. Effective approaches to integration included robust connections between health care systems and LTSS providers, leveraging existing state LTSS infrastructure, and utilizing Area Agencies on Aging for care coordination. Barriers to effective integration included complex waiver programs, service carve outs, and weak collaborative relationships.
PY - 2025
SN - 0733-4648
SP - 7334648251398601
ST - Coordinating and Integrating Long-Term Services and Supports With Medical Services to Reduce Long-Stay Nursing Facility Use for Dually Eligible Medicare-Medicaid Beneficiaries
T1 - Coordinating and Integrating Long-Term Services and Supports With Medical Services to Reduce Long-Stay Nursing Facility Use for Dually Eligible Medicare-Medicaid Beneficiaries
T2 - J Appl Gerontol
TI - Coordinating and Integrating Long-Term Services and Supports With Medical Services to Reduce Long-Stay Nursing Facility Use for Dually Eligible Medicare-Medicaid Beneficiaries
U1 - Healthcare Disparities
U3 - 10.1177/07334648251398601
VO - 0733-4648
Y1 - 2025
ER -