Aging & Disability

Aging and disability programs provide a wide range of health and social services and supports needed by people who are limited in their capacity for self-care due to physical, cognitive, or mental disabilities. Programs aim to help older people and individuals with disabilities live independently for as long as possible, with access to quality health care and long-term services and supports to manage their conditions.

Supportive care for persons with disabilities is provided in institutional, residential, and home- and community-based settings. The majority of care at home is provided informally by family and friends, who most often give care without compensation. A wide range of formal care providers supplement these caregivers. The Medicaid program accounts for nearly two-thirds of all national spending for long-term services and supports. In addition, the Older Americans Act, through the aging services network, provides a range of services to help older people remain independent in their homes.

The Forum's work on aging and disability focused on delivery and financing of long-term services and supports, as well as chronic care management, for the vulnerable elderly and people with disabilities.

Medicaid Payment for Housing-Related Services: Building on Early Experiences
Forum Session — February 26, 2016
Author: Jennifer Jenson, MPH, MPP

Geriatric-Friendly Emergency Departments: Better Options for Patients and Providers?
Forum Session — February 19, 2016
Author: Lisa Sprague, MBA

Hospital Discharge Planning in Medicare: Current Requirements and Proposed Changes
The Basics — February 9, 2016
Author: Sally Coberly, PhD

Accountable Care Organizations (ACOs): Lessons from the Medicare Shared Savings Program
Forum Session — November 13, 2015
Author: Sally Coberly, PhD

Aging in America: Current and Future Trends in Health, Income, Assets and Personal Health Care Spending
Fundamentals Briefing — November 6, 2015
Author: Sally Coberly, PhD

Coordinating Care for Beneficiaries Eligible for Both Medicare and Medicaid: An Update on the "Duals Demos"
Forum Session — October 30, 2015
Author: Sally Coberly, PhD

Improving the Quality and Efficiency of Care for Older Adults: Lessons From the Field
Forum Session — September 18, 2015
Author: Sally Coberly, PhD

Site-Neutral Payments for Post-Acute and Ambulatory Care Services: What’s at Stake?
Forum Session — June 5, 2015
Author: Sally Coberly, PhD

Annual Report 2014
Annual Report — April 1, 2015
Author: Forum Staff

Pioneer ACOs: The Frontier of Delivery System Reform?
Forum Session — June 13, 2014
Author: Sally Coberly, PhD

Coordinating Chronic Care: Will New Incentives Spur Primary Care-Specialist Collaboration?
Forum Session — June 6, 2014
Author: Lisa Sprague, MBA

Transforming Payment and Health Care Delivery: Early Reports from the State Innovation Model (SIM) Initiative
Forum Session — April 18, 2014
Author: Jessamy Taylor, MPP

Annual Report 2013
Annual Report — April 1, 2014
Author: Forum Staff

National Spending for Long-Term Services and Supports (LTSS), 2012
The Basics — March 27, 2014
Author: Carol V. O'Shaughnessy, MA

Sorting Out the Complex World of Medicare Post-Acute Care
Forum Session — March 18, 2014
Authors: William J. Scanlon, PhD, Senior Consultant & Sally Coberly, PhD

Management of Chronic Care Needs: What Will It Really Take to Coordinate Care?
Forum Session — March 14, 2014
Author: Lisa Sprague, MBA

Money Follows the Person (MFP) Rebalancing Demonstration: A Work in Progress
Background Paper No. 85 — February 21, 2014
Author: Carol V. O'Shaughnessy, MA

Medicaid Health Homes: Delivery System Glue for People with Chronic Health Conditions
Forum Session — December 13, 2013
Author: Jessamy Taylor, MPP

CMS-State Demonstration for Medicare-Medicaid Beneficiaries: Implementing the Financial Alignment Initiative
Forum Session — December 6, 2013
Author: Carol V. O'Shaughnessy, MA

Medicaid Home- and Community-Based Services Programs Enacted by the ACA: Expanding Opportunities One Step at a Time
Background Paper No. 86 — November 19, 2013
Author: Carol V. O'Shaughnessy, MA

The Commission on Long-Term Care: Background Behind the Mission
The Basics — October 17, 2013
Author: Carol V. O'Shaughnessy, MA

State Progress in Implementation of Home- and Community-Based Service Programs Enacted by the ACA
Forum Session — September 27, 2013
Author: Carol V. O'Shaughnessy, MA

Transforming Behavioral Health Practice, Payment, and Policy: Too Fast, Too Slow, or Just Right?
Forum Session — September 20, 2013
Author: Jessamy Taylor, MPP

Restructuring Medicare Cost Sharing: Exploring Options to Protect Low-Income Beneficiaries
Forum Session — August 2, 2013
Author: Sally Coberly, PhD

State Variation in Long-Term Services and Supports: Location, Location, Location
Forum Session — July 19, 2013
Author: Carol V. O'Shaughnessy, MA

The Affordable Care Act and HIV/AIDS: Implications for Coverage, Access to Care, and Payment
Forum Session — July 19, 2013
Author: Jessamy Taylor, MPP

EMS "Hot Spotting": San Diego's Experience Creating a System of Care for Frequent Users of Emergency Medical Services
Forum Session — June 14, 2013
Author: Jessamy Taylor, MPP

Health Policy Essentials: Aging in America: Trends in Income, Health, and Personal Health Care Spending
Fundamentals Briefing — April 12, 2013
Author: Carol V. O'Shaughnessy, MA

Annual Report 2012
Annual Report — April 1, 2013
Author: Forum Staff

Pursuing High-Quality Care for an Aging Population: Challenges and Opportunities
Forum Session — March 29, 2013
Author: Lisa Sprague, MBA

Health Policy Essentials: Medicaid, CHIP, and Long-Term Services and Supports (LTSS)
Fundamentals Briefing — March 15, 2013
Authors: Kathryn Linehan & Carol V. O'Shaughnessy, MA

Assisted Living: Facilities, Financing, and Oversight
The Basics — January 29, 2013
Author: Carol V. O'Shaughnessy, MA

Family Caregivers: The Primary Providers of Assistance to People with Functional Limitations and Chronic Impairments
Background Paper No. 84 — January 11, 2013
Author: Carol V. O'Shaughnessy, MA

The Community Living Assistance Services and Supports (CLASS) Act: Major Legislative Provisions
The Basics — January 3, 2013
Author: Carol V. O'Shaughnessy, MA

Assisted Living Facilities and Their Growing Role in Long-Term Services and Supports (LTSS)
Forum Session — November 30, 2012
Author: Carol V. O'Shaughnessy, MA

Breaking Down Silos of Care: Integration of Social Support Services with Health Care Delivery
Forum Session — October 19, 2012
Author: Carol V. O'Shaughnessy, MA

Medicaid Managed Long-Term Services and Supports (MMLTSS): Lessons from Three States
Forum Session — October 5, 2012
Author: Carol V. O'Shaughnessy, MA

Is Health Care Eating Our Lunch? The Impact of Cost Trends on Workers and Retirees
Forum Session — July 20, 2012
Author: Sally Coberly, PhD

Medicaid Managed Long-Term Services and Supports (MMLTSS): Increasing State Interest and Implications for Consumers, Quality of Care, Providers, and Costs
Forum Session — May 11, 2012
Author: Carol V. O'Shaughnessy, MA

Long-Term Services and Supports (LTSS): Arlington County's Integrated Approach
Site Visit — April 13, 2012
Authors: Carol V. O'Shaughnessy, MA & Lisa Sprague, MBA

Targeting High-Cost Medicare Beneficiaries to Improve Care and Reduce Spending: Finding the Bull’s-Eye
Forum Session — March 9, 2012
Author: Sally Coberly, PhD

Older Americans Act of 1965: Programs and Funding
The Basics — February 23, 2012
Author: Carol V. O'Shaughnessy, MA

Improving Care for Dual Eligible Medicare-Medicaid Beneficiaries: One Size Does Not Fit All
Forum Session — January 27, 2012
Author: Carol V. O'Shaughnessy, MA

The Aging Services Network: Serving a Vulnerable and Growing Elderly Population in Tough Economic Times
Background Paper No. 83 — December 13, 2011
Author: Carol V. O'Shaughnessy, MA

Mission Possible? Saving on Health Care Costs by Reducing Unnecessary Services
Forum Session — December 2, 2011
Author: Michele J. Orza, ScD

Preventing Hospital Readmissions: How Can Care Transitions for Medicare Beneficiaries Be Improved?
Forum Session — October 28, 2011
Author: Carol V. O'Shaughnessy, MA

Revisiting Financing and Delivery of Care to Duals: One Size May Not Fit All
Special Briefing — October 21, 2011
Author: Carol V. O'Shaughnessy, MA

Aligning Graduate Medical Education with Public Policy
Background Paper No. 82 — September 14, 2011
Author: Rob Cunningham, Consultant

Medical Care for the Elderly Living at Home: Home-Based Primary Care (HBPC) and Hospital-at-Home Programs
Forum Session — July 22, 2011
Author: Carol V. O'Shaughnessy, MA

Rocky Mountain Highs and Lows: Efforts to Improve Health and Reduce Costs in Denver
Site Visit — May 31–June 2, 2011
Authors: Michele J. Orza, ScD & Jessamy Taylor, MPP

Boomers and the Budget: Implications of an Aging Society
Forum Session — May 13, 2011
Author: Carol V. O'Shaughnessy, MA

Managed Care for Medicaid Beneficiaries with Disabilities: How Does It Work?
Forum Session — May 6, 2011
Author: Judith D. Moore

Private Long-Term Care Insurance: Where Is the Market Heading?
Forum Session — April 15, 2011
Author: Sally Coberly, PhD

Health Policy Essentials: The Fundamentals of Long-Term Services and Supports
Fundamentals Briefing — April 1, 2011
Author: Carol V. O'Shaughnessy, MA

Caring for Patients with Advanced and Serious Illnesses: Changing Medical Practice and Patient Expectations
Forum Session — March 18, 2011
Author: Carol V. O'Shaughnessy, MA

The Elder Justice Act: Addressing Elder Abuse, Neglect, and Exploitation
The Basics — November 30, 2010
Author: Carol V. O'Shaughnessy, MA

Aging and Disability Resource Centers (ADRCs): Federal and State Efforts to Guide Consumers Through the Long-Term Services and Supports Maze
Background Paper No. 81 — November 19, 2010
Author: Carol V. O'Shaughnessy, MA

Focus on Reform: Medicaid Long-Term Services and Supports (LTSS) Provisions in PPACA
Forum Session — October 29, 2010
Author: Carol V. O'Shaughnessy, MA

Medicare and Medicaid Dual Eligibles: Meeting Diverse, Complex, and Costly Needs
Forum Session — July 23, 2010
Author: Christie Provost Peters

Focus on Reform: Long-Term Services and Supports (LTSS) and the CLASS Act
Forum Session — June 18, 2010
Author: Carol V. O'Shaughnessy, MA

Transforming Health Care Delivery: Insights from the New Orleans Safety Net
Forum Session — April 16, 2010
Authors: Jessamy Taylor, MPP & Michele J. Orza, ScD

The State Health Insurance Assistance Program (SHIP)
The Basics — March 29, 2010
Author: Carol V. O'Shaughnessy, MA

Ensuring Nursing Home Quality: Continuing Challenges to Oversight and Enforcement of Nursing Home Reform
Forum Session — March 25, 2010
Author: Carol V. O'Shaughnessy, MA

The Role of Ombudsmen in Assuring Quality for Residents of Long-Term Care Facilities: Straining to Make Ends Meet
Background Paper No. 71 — December 2, 2009
Author: Carol V. O'Shaughnessy, MA

Linking Housing and Supportive Services for the Frail Elderly: Challenges and Opportunities
Forum Session — October 23, 2009
Author: Carol V. O'Shaughnessy, MA

Lessons in Patient Engagement: Motivating Patients to Manage Their Chronic Conditions and Health Care Utilization
Forum Session — October 2, 2009
Author: Carol V. O'Shaughnessy, MA

High Rehospitalization Rates: Causes, Costs, and Accountability
Forum Session — May 29, 2009
Author: Laura A. Dummit

Resilience and Renaissance: Efforts to Rebuild a Healthier New Orleans
Site Visit — May 26–28, 2009
Authors: Michele J. Orza, ScD & Jessamy Taylor, MPP

Coordinating Care for People with Multiple Chronic Conditions: The Guided Care Model and Other Innovative Approaches
Site Visit — April 17 & August 7, 2009
Authors: Judith D. Moore & Carol V. O'Shaughnessy, MA

Promising Models of Care Coordination for Adults with Multiple Chronic Conditions: Getting Closer to the Holy Grail?
Forum Session — April 3, 2009
Author: Carol V. O'Shaughnessy, MA

Coordinating Care for Adults with Multiple Chronic Conditions: Searching for the Holy Grail
Forum Session — March 27, 2009
Author: Carol V. O'Shaughnessy, MA

Long-Term Services and Supports: Consumers in Charge—Consumer Direction and Money Follows the Person
Forum Session — November 7, 2008
Author: Carol V. O'Shaughnessy, MA

Community-Based Long-Term Care in Milwaukee: Wisconsin Still Ahead
Site Visit — August 11–13, 2008
Authors: Judith D. Moore, Carol V. O'Shaughnessy, MA & Lisa Sprague, MBA

Medicare's Hospice Benefit: In the Spotlight
Forum Session — August 1, 2008
Author: Mary Ellen Stahlman

Medicare Demonstrations
The Basics — July 30, 2008
Author: Amanda Cassidy, Consultant

Medicaid and SCHIP Waivers
The Basics — July 30, 2008
Author: Cynthia Shirk, Consultant

Shaping Medicaid and SCHIP through Waivers: The Fundamentals
Background Paper No. 64 — July 22, 2008
Author: Cynthia Shirk, Consultant

The Fundamentals of Medicare Demonstrations
Background Paper No. 63 — July 22, 2008
Author: Amanda Cassidy, Consultant

Policies for an Aging America: Looking Beyond the Averages
Forum Session — May 9, 2008
Author: Carol V. O'Shaughnessy, MA

State Long-Term Care Strategies: Approaches to Managing Care and Controlling Costs
Forum Session — April 25, 2008
Author: Carol V. O'Shaughnessy, MA

The Aging Services Network: Accomplishments and Challenges in Serving a Growing Elderly Population
Background Paper — April 11, 2008
Author: Carol V. O'Shaughnessy, MA

Running Up the Health Care Tab: Will We Have Buyer's Remorse?
Forum Session — January 17, 2008
Authors: Mary Ellen Stahlman & Christie Provost Peters

Children's Behavioral Health Services in Baltimore: Walking the Continuum
Site Visit — September 30–October 1, 2007
Author: Jennifer Ryan

Informal Care of the Frail Elderly: Policy and Practices to Support Family Caregivers
Forum Session — September 21, 2007
Author: Carol V. O'Shaughnessy, MA

Community-Based Long-Term Care: Wisconsin Stays Ahead
Site Visit — August 8–10, 2007
Authors: Judith D. Moore, Carol V. O'Shaughnessy, MA & Lisa Sprague, MBA

Trading Places: Real Choice Systems Change Grants and the Movement to Community-Based Long-Term Care Supports
Issue Brief No. 822 — May 30, 2007
Author: Cynthia Shirk, Consultant

Fairfax County's Commitment: A Housing and Health Continuum for Seniors
Site Visit — March 2, 2007
Authors: Judith D. Moore & Lisa Sprague, MBA

Rebalancing Long-Term Care: The Role of the Medicaid HCBS Waiver Program
Background Paper — March 3, 2006
Author: Cynthia Shirk, Consultant

Financing Health Care in Retirement: A Day Late and a Dollar Short?
Forum Session — February 24, 2006
Author: Sally Coberly, PhD

Health Benefits in Retirement: Set for Extinction?
Background Paper — February 8, 2006
Author: Mark Merlis, Consultant

Understanding the Role of Medicaid in Assisting People with Disabilities
Forum Session — July 22, 2005
Author: Randy A. Desonia

Financing Long-Term Care: Will Insurance Make the Difference?
Forum Session — October 22, 2004
Author: Randy A. Desonia

The Promise and the Reality of Long-Term Care Insurance
Background Paper — July 31, 2004
Author: Randy A. Desonia

Medicare's Chronic Care Improvement Pilot Program: What Is Its Potential?
Issue Brief No. 797 — May 10, 2004
Author: Nora Super

Veterans' Health Care: Balancing Resources and Responsibilities
Issue Brief No. 796 — April 1, 2004
Author: Lisa Sprague, MBA

Expanding Community-Based Care: Is the Olmstead Decision Making a Difference?
Forum Session — November 25, 2003
Author: Randy A. Desonia

Bridging Silos, Part I: Linkages among the DI, SSI, Medicare, and Medicaid Programs
Background Paper — November 14, 2003
Author: Karen Matherlee

Bridging Silos, Part II: DI, SSI, Medicare, and Medicaid Issues and Initiatives
Background Paper — November 14, 2003
Author: Karen Matherlee

Dually Eligible for Medicare and Medicaid: Two for One or Double Jeopardy?
Forum Session — October 22, 2003
Authors: Nora Super & Jennifer Ryan

Dually Eligible for Medicare and Medicaid: Two for One or Double Jeopardy?
Issue Brief No. 794 — September 30, 2003
Authors: Jennifer Ryan & Nora Super

Depression in Primary Care: Making Good Care Good Business
Forum Session — June 6, 2003
Author: Veronica V. Goff, Consultant

Medicare and Chronic Conditions: Breaking Down Barriers to Better Care
Forum Session — March 26, 2003
Author: Nora Super

Is Community Care a Civil Right? The Unfolding Saga of the Olmstead Decision
Background Paper — March 12, 2003
Author: Randy A. Desonia

The Medicare and Medicaid Intersection: Caring for Arizona's Seniors
Site Visit — November 12–14, 2002
Authors: Nora Super, Lisa Sprague, MBA & Judith D. Moore

Prescription Drugs in Nursing Homes: Managing Costs and Quality in a Complex Environment
Issue Brief No. 784 — November 12, 2002
Authors: Dan Mendelson, Rajeev Ramchand, Richard Abramson, MD & Anne Tumlinson, Consultants

Too Few? Too Many? The Right Kind? Physician Supply in an Aging and Multicultural Society
Forum Session — September 10, 2002
Author: Nora Super

Managing Advanced Illness: A Quality and Cost Challenge to Medicare, Medicaid, and Private Insurers
Forum Session — July 18, 2002
Author: Karen Matherlee

Modernizing Medicare: The Homebound Rule and Next Steps
Small-Group Session — July 10, 2002
Author: Judith D. Moore

Managing Advanced Illness: A Quality and Cost Challenge to Medicare, Medicaid, and Private Insurers
Issue Brief No. 779 — June 20, 2002
Author: Karen Matherlee

Consumer Direction in Long-Term Care: Implications for Caregivers
Forum Session — April 12, 2002
Author: Nora Super

Transitions along the Continuum of Care: Elderly and Disabled Persons in New York
Site Visit — March 4–5, 2002
Authors: Lisa Sprague, MBA & Nora Super

Who Will Be There to Care? The Growing Gap between Caregiver Supply and Demand
Background Paper — January 23, 2002
Author: Nora Super

State-Based Pharmaceutical Assistance Programs: Temporary Fix or Lessons for Medicare?
Issue Brief No. 762 — April 25, 2001
Author: Robin J. Strongin, Consultant

State-Based Pharmaceutical Assistance Programs: Temporary Fix or Lessons for Medicare?
Forum Session — April 25, 2001
Author: Robin J. Strongin, Consultant

Health Coverage Transitions for Young Adults with Disabilities
Small-Group Session — March 28, 2001
Author: Judith D. Moore

Caring for the Elderly: Oregon's Pioneers (Portland, Oregon)
Site Visit — November 13–15, 2000
Authors: Nora Super & Lisa Sprague, MBA

Site Visit to Arizona — Managed Medicaid: Arizona's AHCCCS Experience
Site Visit — January 11–14, 2000
Authors: Nora Super, Lisa Sprague, MBA & Judith D. Moore

Implementing the BBA: The Challenge of Moving Medicare Post-Acute Services to PPS
Issue Brief No. 743 — July 7, 1999
Author: Karen Matherlee

Implementing the BBA: The Challenge of Moving Medicare Post-Acute Services to PPS
Forum Session — July 7, 1999
Author: Karen Matherlee

Examining the Links between Retirement and Health Insurance: Implications for Medicare Eligibility
Issue Brief No. 733 — March 24, 1999
Author: Nora Super

Examining the Links between Retirement and Health Insurance: Implications for Medicare Eligibility
Forum Session — March 24, 1999
Author: Nora Super

Filling the Geriatric Gap: Is the Health System Prepared for an Aging Population?
Issue Brief No. 729 — January 25, 1999
Author: Janet Firshein, Consultant

Filling the Geriatric Gap: Is the Health System Prepared for an Aging Population?
Forum Session — January 25, 1999
Authors: Janet Firshein, Consultant & Nora Super

Communicating to Beneficiaries about Medicare+Choice: Opportunities and Pitfalls
Forum Session — July 24, 1998
Authors: Nora Super & Sandra M. Foote

Restructuring the VA Health Care System: Safety Net, Training, and Other Considerations
Issue Brief No. 716 — March 25, 1998
Author: Barbara Skydell

Restructuring the VA Health Care System: Safety Net, Training, and Other Considerations
Forum Session — March 25, 1998
Author:

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