New Models of Community Care for Older Adults and People with Disabilities
The Affordable Care Act, Medicaid 1115 waivers, and other policy initiatives are changing our nation’s health and long-term care systems, offering new opportunities and models for community-based supports and services for older adults and individuals with disabilities. ACL is working with our federal and state partners to lead and support the implementation of many of these efforts.
Community-based Care Transitions Program
ACL works closely with CMS on implementation of the the Community-based Care Transitions Program (CCTP), created by Section 3026 of the Affordable Care Act, which tests models for improving care transitions from the hospital to other settings and reducing readmissions for high-risk Medicare beneficiaries. The goals of the CCTP are to improve transitions of people with Medicare from the inpatient hospital setting to other care settings, to improve quality of care, to reduce readmissions for high risk beneficiaries, and to document measurable savings to the Medicare program. Community-based organizations (CBOs) serving older adults and individuals with disabilities play a vital role in facilitating such transitions, and are eligible to apply for CCTP. In selecting CBOs, preference is given to Administration on Aging (AoA) grantees that provide care transition interventions in conjunction with multiple hospitals and practitioners and/or entities that provide services to medically-underserved populations, small communities, and rural areas. For more information about CCTP, visit CMS CCTP.
Managed Long-Term Services and Supports
The rapid movement toward managed long-term services and supports (MLTSS) in many states has major implications for aging and disability networks and the populations they serve. Managed long-term services and supports offer both opportunities and challenges in terms of advocating with and for individuals receiving services regarding the design and implementation of systems, and expanding business lines with managed care organizations through the creation of service contracts and providing services to managed care plan members. MLTSS systems also offer aging and disability networks an important opportunity to better connect many of the services that they already provide, including network and partnership development, options counseling, person-centered planning, care and transitions management, chronic disease self-management, and benefits outreach and enrollment, as a service package that managed care plans can purchase. ACL is funding a team of organizations—n4a, NASUAD, Boston University, The Lewin Group, HCD International and NCOA—to provide training and technical assistance to aging and disability networks to increase their capacity to play leading roles in the design and delivery of MLTSS in their states. Learn more about the MLTSS initiative (PDF, 0.8MB).
Affordable Care Act State Health Insurance Assistance Program (SHIP) and Aging and Disability Resource Center (ADRC) Options Counseling for Medicare-Medicaid Individuals in States with Approved Financial Alignment Models
As part of the Centers for Medicare & Medicaid Services’ (CMS) Financial Alignment Initiative, states and CMS are collaborating to integrate care and financing for people with Medicare and Medicaid, and improve coordination between the federal government and states. To support this important effort, ACL is partnering with the Centers for Medicare & Medicaid Services (CMS) to provide financial assistance to SHIPs and/or ADRCs to provide options counseling to Medicare-Medicaid Individuals (dual eligibles) to ensure that these individuals have access to an unbiased and consumer friendly source of information and counseling—distinct from the Demonstration Plans and Enrollment Brokers—to help them make informed decisions about options they have for receiving their Medicare and Medicaid benefits. For more information about this funding opportunity, Read more about this ACL partnership initiative with CMS (PDF, 0.4MB).