In 2003, Congress directed the Centers for Medicare & Medicaid Services (CMS) to commission a study in up to 8 States to explore the various management techniques and programmatic features that States have put in place to rebalance their Medicaid long-term supportive services (LTSS) systems and their investments in long-term support services towards community care. The states of Arkansas, Florida, Minnesota, New Mexico, Pennsylvania, Texas, Vermont, and Washington participated in the resulting 3-year collaborative study (hereafter called the Rebalancing Research). For the study, CMS defined rebalancing as achieving "a more equitable balance between the proportion of total Medicaid long-term support expenditures used for institutional services (i.e., Nursing Facilities [NF] and Intermediate Care Facilities for the Mentally Retarded [ICFs-MR]) and those used for community-based supports under its State Plan and waiver options;" in an LTSS system that offers "a reasonable array of balanced options, particularly adequate choices of community and institutional options." 

The study took place between October 2004 and June 2008, was a longitudinal study with qualitative and quantitative components that utilized a wide variety of methods. Among the many products generated are:

•      8 baseline case studies for each of the 8 states covering a period up to July 2005

•      An 8-state update report, covering the period from August 2005 to July 2006

•      8 final cases studies for each of the 8 states, covering the period until December 2007

•      6 cross-cutting Topic Papers dealing with themes in Rebalancing

•      6 Quantitative Chartbooks

The Final Report

The two purposes of the Final Report are: 1) to summarize the methods, products and findings of this complex project, and provide a roadmap to its products; and 2) to suggest conclusions and recommendations that might be helpful to State officials, legislators, advocates, and providers and CMS on approaches to increase and improve long-term supports in the community for people with disabilities of all ages, enhance participant choice, and reduce reliance on institutions.

Please see below, under Related Links Outside CMS, the Rebalancing Research link .

Downloads
Related Links Inside CMS
Related Links Outside CMS
Rebalancing Research

Page Last Modified: 11/24/2008 8:25:12 AM
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