Medicaid: What to Watch in 2022
As 2022 kicks off, a number of issues are at play that could affect coverage and financing under Medicaid. This issue brief examines key issues to watch in Medicaid in the year ahead.
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Assessing Online Availability of At-Home COVID-19 Tests Ahead of Private Insurance Reimbursement
Issue BriefThis data note explores findings from on an 8-day online search for at home COVID-19 tests at major retailers. The findings are described against the backdrop of the Biden Administration policy requiring plans to cover the cost of these tests. We find that these tests remain hard to find and that this limited availability could negatively affect the success of the reimbursement strategy.
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State Delivery System and Payment Strategies Aimed at Improving Outcomes and Lowering Costs in Medicaid
Issue BriefState Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. This brief examines what delivery system and payment reform initiatives are in place across states; how are states linking financial incentives and using transparency to improve quality and outcomes; and how are states leveraging managed care plan contracts to advance delivery system…
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Unvaccinated COVID patients cost the U.S. health system billions of dollars
Issue BriefThis updated analysis for the Peterson-KFF Health System Tracker estimates that the preventable costs of treating unvaccinated patients in hospitals total $13.8 billion during the six-month period from June through November when the delta variant led to a surge in admissions.
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State Policies Connecting Justice-Involved Populations to Medicaid Coverage and Care
Issue BriefThe COVID-19 pandemic has magnified pre-existing health disparities for justice-involved populations, with coronavirus infection rates among incarcerated populations higher than overall infection rates in nearly all states. Justice-involved individuals are disproportionately low-income and often have complex and/or chronic conditions, including behavioral health needs. Although the statutory inmate exclusion policy prohibits Medicaid from covering services provided during incarceration (except for inpatient services), states may take other steps to leverage Medicaid to improve continuity of care for…
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Community Health Centers in the U.S. Territories and the Freely Associated States
Issue BriefThe U.S territories and the Freely Associated States (FAS) have faced an array of longstanding fiscal and health challenges, made worse by recent natural disasters and the coronavirus pandemic. Community health centers are an important part of health care system in the territories and FAS, providing access to a range of primary care services to low-income and vulnerable individuals. Based on findings from a survey of health centers, data from the Uniform Data System (UDS),…
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Explaining the New COVID-19 Vaccination Requirement for Health Care Provider Staff
Issue BriefThis issue brief examines the new regulations, explains the status of the pending litigation, and identifies issues to watch.
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Characteristics of Vaccinated Patients Hospitalized with COVID-19 Breakthrough Infections
Issue BriefThis brief describes the characteristics of fully vaccinated hospitalized patients who have COVID-19 breakthrough infections, in comparison to people who are not fully vaccinated and hospitalized with COVID-19.
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Medicaid Enrollment Churn and Implications for Continuous Coverage Policies
Issue BriefRecent policy actions and proposals in Medicaid have renewed focus on the problem of churn, or temporary loss of coverage in which enrollees disenroll and then re-enroll within a short period of time. We find that 10% of full-benefit enrollees have a gap in coverage of less than a year, and rates are higher for children and adults compared to aged and people with disabilities. Churn has implications for access to care as well as…
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Medicaid Outpatient Prescription Drug Trends During the COVID-19 Pandemic
Issue BriefThis data note describes Medicaid prescription drug utilization and spending trends in calendar year 2020 compared to previous years to explore how the pandemic impacted Medicaid prescription drug utilization and spending.