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Witness: Promote Medicaid return-to-home programs

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The head of a state government think tank says state Medicaid programs are doing a better job managing their nursing home benefits programs than most people realize.

Alan Weil, executive director of the National Academy for State Health Policy, defended Medicaid long-term care (LTC) programs Monday.

Weil was testifying at a hearing on Medicaid organized by the House Energy & Commerce health subcommittee. The subcommittee posted a video of the hearing on the Energy & Commerce website.

Medicare — the federal health program for the elderly and people with disabilities — does cover home health care but generally does not cover nursing home care.

Medicaid — a state and federal program that is supposed to serve the poor — does cover nursing home care. Critics have argued that some state eligibility rules for Medicaid nursing home benefits eligibility rules are so loose that residents with expensive homes and other valuable assets can qualify.

In the real world, Weil said, “the nursing home census stayed flat.”

States have made good use of home-based and community-based health care programs to keep people in their homes, Weil said.

Weil said Washington state has made another advance that other states should try to emulate: Helping some people who are already using nursing home care to return home.

Washington state has succeeded with the return-to-home program by assigning case managers to develop and implement transition plans, Weil said.

In some cases, Weil said, the return-to-home program can people who have lived in nursing homes for extended periods and need extra help to return to the community.

The Washington state return-to-home program has helped that state reduce the number of Medicaid-supported nursing home residents by 6 percent between 2005 and 2010, Weil said.

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