National policymakers and state Medicaid leaders are paying greater attention to better management of long-term supports and services (LTSS). The reasons are obvious: aging of the baby boom population; severe fiscal pressures; the disproportionate costs of those with serious long-term conditions; an ongoing over-reliance on institutional care; and the fact that LTSS remains almost entirely in the unmanaged fee-for-service system. Yet an array of financial, administrative, bureaucratic, and political obstacles impede states from rebalancing their LTSS programs toward greater emphasis on home-and community-based alternatives.

This brief outlines initial policy recommendations for reforming the nation's Medicaid-funded LTSS system to support more cost-effective and consumer-oriented long-term care options.

It provides a useful summary 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

(abstract from: http://www.chcs.org/publications3960/publications_show.htm?doc_id=1253871).