Shifting spending and delivery of long-term services and supports (LTSS) from institutions to the home and community is often referred to as rebalancing. This report and brief describe variation in LTSS rebalancing between 2016 and 2019 by enrollee age, health condition, and demographic factors.
Office of Behavioral Health, Disability, and Aging Policy (BHDAP)
The Office of Behavioral Health, Disability, and Aging Policy (BHDAP) focuses on policies and programs that support the independence, productivity, health and well-being, and long-term care needs of people with disabilities, older adults, and people with mental and substance use disorders.
Note: BHDAP was previously known as the Office of Disability, Aging, and Long-Term Care Policy (DALTCP). Only our office name has changed, not our mission, portfolio, or policy focus.
The Division of Behavioral Health Policy is responsible for the analysis, coordination, research and evaluation of policies related to mental and substance use disorders, also referred to as behavioral health. The division is the focal point for policy development and analysis related to the financing, access/delivery, organization, and quality of services for people with mental and substance use disorders, including those supported or financed by Medicaid, Medicare, and the Substance Abuse and Mental Health Services Administration (SAMHSA).
The Division of Long-Term Services and Supports is responsible for the analysis, coordination, and research and evaluation of policies related to institutional and community-based long-term care and supportive services, including formal and informal caregiving. The Division is the focal point for policy development and analysis related to the financing, delivery, organization, and quality of long-term care services and supports, including those supported or financed by private insurers, Medicaid, Medicare, and the Administration for Community Living (ACL).
The Division of Disability and Aging Policy is responsible for policy and data development, coordination, research and evaluation of policies and programs focused on the functioning and well-being of persons with disabilities and older adults. The Division is the focal point for crosscutting disability and aging collaboration within the Department and across other federal agencies. Alzheimer’s disease and related dementias and intellectual and developmental disabilities, including Autism Spectrum Disorder, are notable areas of engagement and expertise.
Helpful Information:
Reports
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Behavioral Health Prevalence, Utilization, and Spending Among Older Adult Medicare Beneficiaries: A Chartbook
Older adults with behavioral health disorders often experience worse health and functional outcomes, have higher rates of emergency department visits, use more medications, and have higher health care costs than those without a behavioral health disorder. There is need for a greater understanding of the extent to which older adults experience behavioral health disorders.
ASPE Issue Brief, Report
Long-Term Services and Supports Reform
While the likelihood of needing any long-term services and supports (LTSS) is roughly a coin flip, the cost if one needs assistance for a long period of time can be catastrophic. For example, about one-in-five Americans turning age 65 today will have long-term care costs exceeding $200,000.
ASPE Issue Brief, Report
Behavioral Health Crisis Services: Insurance Reimbursement
The National Guidelines for Behavioral Health Crisis Care from the Substance Abuse and Mental Health Services Administration (SAMHSA) call for a sustainable infrastructure to respond to behavioral health crises, through crisis services that are accessible to anyone, anywhere, at any time.
Report
Definitions and Occupational Characteristics of Direct Support Professionals
This study explores duties and activities that distinguish the DSP occupation from other direct care workforce occupations to inform the consideration of a DSP SOC code and other workforce data collection efforts. This study also identifies information beyond what is needed to create a DSP SOC code that states need on the DSP workforce to address policy and workforce planning activities.
ASPE Issue Brief
Hospice Agency Changes of Ownership: An Analysis of Publicly Available Ownership Issue Brief
To improve Medicare provider and supplier enrollment data transparency, in 2023, the Centers for Medicare & Medicaid Services publicly released detailed ownership data, including data on change of ownership transactions, for Medicare-enrolled hospices. This brief presents a descriptive analysis of hospice agency changes of ownership nationally between 2018 and 2022.
Fact Sheet, Report
Medicare Savings Programs: Eligibility and Enrollment Trends
Between 1988 and 1998, Congress established the Medicare Savings Programs (MSPs). MSPs are Medicaid programs that subsidize the cost of Medicare premiums, deductibles, co-insurance, and other cost sharing for Medicare beneficiaries with low incomes.
Report
Barriers to Attention-Deficit/Hyperactivity Disorder Diagnosis in Adults
Attention-deficit/hyperactivity disorder (ADHD) diagnosis and treatment among adults in the United States have increased over the past few decades. However, there are gender, racial, and ethnic disparities in diagnosis and treatment, and underdiagnosis persists.
ASPE Data Point
Beyond Market Concentration: Using Social Network Analysis to Explore Complex Ownership Structures of Nursing Homes Data Point
CMS has actively worked to enhance ownership transparency in the nursing home industry through a series of data releases. This brief utilizes data from these new CMS initiatives to explore ownership and market structures of nursing homes, providing insights into the complexity and dynamics of nursing home ownership.
Report
Implementation of Mobile Medication Units: Findings from a Qualitative Study
In light of the continuing opioid epidemic in the United States, DEA lifted a moratorium on approvals of new mobile medication units (MMUs) to increase access to OTPs. The new DEA guidance also authorized OTPs to add a “mobile component” to their existing registration, eliminating the separate registration requirement for MMUs.