Elders

The rising number of people with Alzheimer's disease presents significant challenges for family members, caregivers, advocates, public policy makers and service providers. Faced with budgetary pressures and concerns about access to care and continuity of care, states are developing managed care programs for elderly Medicaid beneficiaries, reviewing eligibility policies and fine tuning assessment tools used to measure need for long term care. This study focuses on the development of assessment tools and eligibility criteria and explores the implications of these developments for people with Alzheimer's disease and related disorders. The study examined three areas: Medicaid spending patterns, case studies based on activities in two states and the assessment instruments used in selected states.

The Study Group on Long Term Care Options in Maine is a group of interested citizens brought together by the National Academy for State Health Policy at the request of the UNUM Foundation to discuss how Maine provides long term care services to people in need. Because all of us could need long term care if we experience an accident, chronic illness, unexpected birth outcome, or the frailties that can come with age, it is important that citizens learn about, discuss and guide how the current system of care will serve them. We are not experts on long term care but individuals without a specific agenda or organizational viewpoint to advance. We were invited to participate in the Study Group because of our knowledge of Maine and out ability to think creatively about complex issues.  We are from all over the state from Portland to Presque Isle. We see ourselves as potential consumers of long term care, and so bring the voice of the community to some of the issues that policy officials struggle with in financing and delivering a complex array of services to a diverse population.

The purpose of this document is to summarize the current state-of-the-art in managed care for the elderly and to provide states with background information needed to launch their own initiatives to provide quality, cost effective care to the rapidly aging population. As you will see, attempts to truly coordinate primary, preventive, acute, and long term care have been limited, but the demonstrations that do exist show promise. As the health care reform debate unfolds, it is likely that states will seek to do more to manage care for the elderly, and we hope this document provides useful, baseline information.