An Updated Policy Roadmap: Caring for Individuals with Complex Needs

Authors
Lisa Harootunian
Katherine Hayes
G. William Hoagland
Brian O’Gara
Kamryn Perry
Brief/Report
March 2022

Headline

Recommendations for federal policymakers to improve Medicaid for adults with complex needs and improve long-term services and supports for individuals not eligible for Medicaid.

Context

The Bipartisan Policy Center has released more than a dozen reports on policy recommendations to improve complex care. Some of these recommendations, such as those related to dual-eligible special needs plans (D-SNPs), have been enacted into law or incorporated into agency guidance. Given the complicated systems related to home- and community-based services (HCBS) authorities and Medicare and Medicaid coverage, this report identifies recommendations for future action.

Findings

Policy recommendations include proposals to improve health and long-term services and supports through the Medicaid program, as well as recommendations for those not eligible for Medicaid who may also experience catastrophic long-term care costs before they become eligible for Medicaid. Recommendations cover simplifying and streamlining Medicaid HCBS authorities, integrating Medicare and Medicaid for dually eligible individuals, addressing barriers to Medicaid buy-in programs, establishing an HCBS buy-in, improving chronic care, creating a caregiver tax credit, and improving private long-term care insurance.

Takeaways

Federal policymakers can apply these recommendations and related information to improve care for adults with complex needs, especially for dually eligible individuals and individuals requiring long-term services and supports.

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