Medicaid Balancing Incentives Payment Program Brings $3 Billion In Funding To Move Long-Term Care To Community
Open Minds April 30, 2012
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The new Medicaid Balancing Incentives Payment Program is making $3 billion in funding available to states to restructure their long-term care (LTC) systems. The focus of the program is expanding the availability of home- and community-based services (HCBS). The program requires states to implement structural changes, including a “no wrong door”/single entry point system, conflict-free case management services, and a core standardized assessment instrument. In return, the state receives an enhanced federal Medicaid match for new or expanded HCBS provided. As of April 26, 2012, only two states have received a Balancing Incentives Grant – New Hampshire and Maryland.
To participate, eligible states must submit an application that meets programmatic and structural reform requirements. The state is not permitted to restrict LTC eligibility more than the standards already in place as of December 31, 2010. The program is available to states that spent less than 50% of total Medicaid medical assistance expenditures on non-institutionally based long-term care services and supports (LTSS) for fiscal year 2009. States that spent 25-50% on non-institutionally-based LTSS are eligible for a 2% enhanced federal Medicaid match. These states must reach 50% of total LTSS expenditures on non-institutionally based LTSS by September 30, 2015.
States that spent less than 25% on non-institutionally based LTSS are eligible for 5% enhanced Medicaid match. Mississippi is the only state that fits this requirement and is eligible to receive a 5% enhanced federal match. If Mississippi were to participate, it would be required to reach 25% of total LTSS expenditures on non-institutionally based LTSS by September 30, 2015.
A link to the full text of “State Medicaid Director Letter: Balancing Incentive Payments Program” may be found in The OPEN MINDS Circle Library at www.openminds.com/library/110110dsstmdcdltrmbipp.htm.
OPEN MINDS last reported on the first Medicaid Balancing Incentives award in “New Hampshire Receives First Medicaid Balancing Incentives Grant To Expand HCBS Long-Term Care Services.” The article is available at www.openminds.com/market-intelligence/basic/omolfree/040912ds3.htm.
OPEN MINDS reported on the second Medicaid Balancing Incentives award in “Maryland Increasing Incentives To Move LTC To Community With Medicaid Balancing Incentives Grant.” The article is available at www.openminds.com/market-intelligence/premium/omol/2012/043012ds4.htm.
OPEN MINDS first reported on the Medicaid Balancing Incentives program in “States Now Have Four Options to Increase Use of Medicaid Community-Based Long-Term Services.” The article is available at www.openminds.com/market-intelligence/basic/omolfree/011612ds3.htm#axzz1qut1Xmcf.
More information about the Balancing Incentives Program is available at www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Balancing/Balancing-Incentive-Program.html (accessed April 6, 2012).
Read more about Mississippi’s institutionalization rates, see “Mississippi Institutionalization Rates Highest In Nation For Consumers With Cognitive Or Mental Disabilities” at http://www.openminds.com/market-intelligence/premium/omol/2012/040912ds2.htm.
For more information, contact: Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244; 202-690-6145; Fax: 202-690-7159; Web site: www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Long-Term-Services-and-Support/Balancing/Balancing-Incentive-Program.html.
Medicaid Balancing Incentives Payment Program Brings $3 Billion In Funding To Move Long-Term Care To Community. (2012, April 30). OPEN MINDS Weekly News Wire.
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