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Short- and Intermediate-Term Trends Affecting Medicaid Policy for Persons with Disability, Chronic Illness, and Special Needs

Brandeis University

Mark Sciegaj

Brandeis University

Linda Long

Brandeis University

Medicaid is a critically important program for accessing health and supportive services for persons with disabilities, chronic illness, and special needs. Because of its size and scope, Medicaid is the leading payer and policy-making entity for this population. Addressing both the complex needs of these individuals and their preference to remain in their communities has led to the expansion of Medicaid beyond its original medical model to one in which it pays for a wider range of services. This article describes three trends affecting the Medicaid program: the continued growth in noninstitutional care alternatives, private financing options for long-term care for older persons with a disability, and the expansion of cash benefit options to more consumer-directed care-delivery models. For each trend, the article also describes a range of policy responses.

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