{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T12:50:32Z","timestamp":1791809432829,"version":"4.3.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100005227","name":"Centers for Medicare and Medicaid Services","doi-asserted-by":"publisher","award":["HHSM-500-2014-00037i"],"award-info":[{"award-number":["HHSM-500-2014-00037i"]}],"id":[{"id":"10.13039\/100005227","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Appl Gerontol"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:p>The Centers for Medicare &amp; Medicaid Services\u2019 Financial Alignment Initiative conducted its demonstration across multiple states to test the impact of integrating care and financing for medical, behavioral, and long-term services and supports (LTSS) for dually eligible Medicare-Medicaid beneficiaries. We analyzed the demonstration\u2019s impact on long-stay nursing facility (NF) use in eight states. All states implemented approaches to improve integration and reduce NF use but only five states favorably impacted long-stay NF utilization. Ohio, Washington, Texas, South Carolina, and Colorado had a 4.22, 3.50, 1.82, 1.46, and 1.30 percentage point decrease in the annual probability of long-stay NF use, respectively, relative to each state\u2019s comparison group. Effective approaches to integration included robust connections between health care systems and LTSS providers, leveraging existing state LTSS infrastructure, and utilizing Area Agencies on Aging for care coordination. Barriers to effective integration included complex waiver programs, service carve outs, and weak collaborative relationships.<\/jats:p>","DOI":"10.1177\/07334648251398601","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:09:59Z","timestamp":1763464199000},"page":"2007-2018","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Coordinating and Integrating Long-Term Services and Supports With Medical Services to Reduce Long-Stay Nursing Facility Use for Dually Eligible Medicare-Medicaid Beneficiaries"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3371-4010","authenticated-orcid":false,"given":"Lauren A. 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CMS releases latest enrollment figures for medicare medicaid and Children\u2019s health insurance program (CHIP). https:\/\/www.cms.gov\/newsroom\/news-alert\/cms-releases-latest-enrollment-figures-medicare-medicaid-and-childrens-health-insurance-program-chip"},{"issue":"9","key":"e_1_3_5_9_1","first-page":"E157","article-title":"Disability, health, and multiple chronic conditions among people eligible for both medicare and medicaid, 2005-2010","volume":"10","author":"Fox M. H.","year":"2013","unstructured":"Fox M. H., Reichard A. (2013). Disability, health, and multiple chronic conditions among people eligible for both medicare and medicaid, 2005-2010. 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