Engagement of Providers and Advocates in a Rebalancing Initiative to Increase HCBS Access for Medicaid Beneficiaries

Published in: Journal of the American Medical Directors Association (2020). doi: 10.1016/j.jamda.2019.12.015

Posted on RAND.org on January 29, 2020

by Daniel Siconolfi, Sangeeta C. Ahluwalia, Regina A. Shih, Esther M. Friedman, Debra Saliba

Read More

Access further information on this document at Elsevier

This article was published outside of RAND. The full text of the article can be found at the link above.

Efforts to rebalance long-term services and supports (LTSS) toward increased home- and community-based services (HCBS) will engage and affect multiple stakeholder groups, including governmental stakeholders (eg, Medicaid administrators) and diverse nongovernmental stakeholders such as service providers, advocates, and consumers. The most recent large-scale rebalancing effort was the Balancing Incentive Program, which incentivized states that were spending less than 50% of Medicaid LTSS expenditures on HCBS to rebalance their LTSS spending toward HCBS. States were required to apply for BIP participation and implement structural changes to their LTSS systems.

Prior research has described perspectives of governmental stakeholders in the context of BIP, but there has been little attention to the perspectives of nongovernmental stakeholders. The ability for states to successfully plan and implement high-quality LTSS programs, including managed LTSS, will undoubtedly require engagement and collaboration between governmental and nongovernmental stakeholders. This study, therefore, offers a description of the type and extent of stakeholder engagement in BIP, which will have relevance to other LTSS policy initiatives.

Research conducted by

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.