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This brief provides and update of the health care and health policy environment in California, discussing the budgetary environment, implementation of the state's "Bridge to Reform" Medicaid waiver, and efforts to prepare for coverage expansions and new coverage options in 2014 under the Affordable Care Act.
This analysis examines the share of Medicare beneficiaries who would be helped over time if the program were to add a limit on out-of-pocket spending to traditional Medicare. This analysis was conducted jointly with the Medicare Payment Advisory Commission (MedPAC) in response to a request made during a Feb. 26, 2013 hearing of the House Ways and Means' Subcommittee on Health.
This study examines quality among health centers relative to Medicaid managed care organizations (MCOs). Chronic care quality among health centers is high; gaps in women’s preventive care are a concern. Lower-performing health centers have very high uninsured and homeless rates. The expansion of Medicaid and private insurance under the ACA may foster gains in health center quality performance.
This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2013, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans, including variations by plan type, and describes the out-of-pocket limits and prescription drug coverage in the Part D “donut hole” provided by the plans in 2013.
The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces. However, effective outreach and enrollment efforts will be key to ensuring that new coverage opportunities translate into increased coverage. Based on a review of existing research, this brief identifies five key lessons learned through previous Medicaid and CHIP experience to help inform outreach and enrollment under the ACA. The brief is…
This brief provides insight into lessons learned from Medicaid and CHIP outreach and enrollment strategies by profiling a successful initiative of the Michigan Primary Care Association to facilitate coverage renewals through a systematic, technology-based reminder system coupled with one-on-one assistance. The brief is part of the “Getting Into Gear for 2014″ series examining key implementation issues as states prepare for the Affordable Care Act (ACA) coverage expansions. Issue Brief (.pdf)
This brief examines the ACA law and new regulations related to the match rates for coverage under the ACA for Medicaid and Children's Health Insurance Program.
This testimony by the Foundation's Karen Pollitz before the Equal Employment Opportunity Commission included background on wellness programs, wellness incentives and nondiscrimination since 1996, and questions and issues related to proposed regulations governing the design and application of wellness programs offered in conjunction with employer-sponsored group health plans.
This brief examines the cost and use of health care among low-income nonelderly adults who are covered by Medicaid relative to their expected service use and costs if they instead had employer-sponsored insurance (ESI) coverage or were uninsured. The analysis controls for a wide array of factors that also influence utilization and spending in an effort to isolate the specific effects of Medicaid coverage. Consistent with previous research, the analysis underscores how Medicaid facilitates access…
Introduction Health spending has been growing at historically low levels in recent years. The Office of the Actuary (OACT) in the Centers for Medicare and Medicaid Services reports that national health spending grew by 3.9% each year from 2009 to 2011, the lowest rate of growth since the federal government began keeping such statistics in 1960. Estimates from the Center for Sustainable Health Spending at the Altarum Institute suggest that the slowdown largely continued into 2012, with health spending…
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