New Approaches for Medicaid: The 1115 Demonstration Evaluation
Prepared for:
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services
Managed Long-Term Services and Supports: Interim Evaluation Report
Medicaid 1115 Demonstrations
Associated Project
The interim outcomes evaluation compares use of specific services among MLTSS enrollees in two states’ programs—New York’s Managed Long Term Care (MLTC) program and Tennessee’s CHOICES program—to services used by a similar group of people receiving LTSS under FFS. The services examined in this report include (1) LTSS, including nursing home care and HCBS provided through 1915(c) waivers or under the state plans, such as personal care services; and (2) hospitalizations. Overall, findings from the interim evaluation of MLTSS indicate mixed results with respect to the goal of rebalancing care from institutional settings to care in home and community based settings. Specifically, we found:
- Higher use of personal care visits in both states with significantly more in New York than in Tennessee
- Higher use of HCBS in New York and among Medicaid-only beneficiaries in Tennessee
- Lower use of institutional care in New York with little change in Tennessee
- Lower use of hospital care (using three outcome measures) in New York
- Slightly more hospital days in Tennessee with inconclusive results on two other hospital care outcomes
Findings also suggest that there is more progress to be made in improving long-term services and supports for Medicaid beneficiaries, as well as improving the availability of robust data.
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