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  • Trends in State Medicaid Programs: Looking Back and Looking Ahead

    Issue Brief

    For 15 years, KCMU and HMA have conducted annual surveys of Medicaid programs across the country. The NAMD has formally collaborated on this project since 2014. This brief provides a look back at the enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care since as well as highlighting more recent data on managed care and delivery system reforms collected as part of this annual survey. Looking ahead, the survey will continue to capture the evolution of the Medicaid program with a focus program changes during economic cycles as well as innovations in payment and delivery system reform.

  • 8 Preguntas & Respuestas sobre Puerto Rico

    Fact Sheet

    La crisis de $73 mil millones de Puerto Rico ha sido tema de los medios de comunicación nacionales, y de debate en el Congreso en los últimos meses.

  • ACA Coverage Expansions and Low-Income Workers

    Issue Brief

    This brief highlights low-income workers and the impact of ACA coverage expansions on this population. Low-income workers may not have access to jobs that provide full-time, full-year employment or jobs with comprehensive benefit packages, including health insurance. Medicaid plays an important role in providing health coverage for low-income workers, and coverage expansions implemented under the ACA have produced substantial coverage gains for low-income workers and a corresponding reduction in the uninsured. However, low-income workers in non-expansion states with incomes too high for Medicaid but too low for subsidies in the Marketplace do not have an affordable coverage option and will likely remain uninsured.

  • CMS’s Final Rule on Medicaid Managed Care: A Summary of Major Provisions

    Issue Brief

    On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.

  • Understanding Medicaid Hospital Payments and the Impact of Recent Policy Changes

    Issue Brief

    Medicaid payments to hospitals, which include base and supplemental payments, play an important role in hospital finances and can affect beneficiaries’ access to care.This brief provides an overview of Medicaid payments for hospitals and explores the implications of the ACA Medicaid expansion, including changes in uncompensated care, as well as payment policy changes on hospital finances.

  • The Louisiana Health Care Landscape

    Fact Sheet

    This fact sheet provides an overview of resident socio-demographic characteristics, population health, health coverage, and the health care delivery system in Louisiana both pre-Hurricane Katrina and in the era of health reform.

  • Connecting the Justice-Involved Population to Medicaid Coverage and Care: Findings from Three States

    Issue Brief

    This brief provides an overview of initiatives to connect the justice-involved population to Medicaid coverage and care in the community in three states—Arizona, Connecticut, and Massachusetts—based on interviews with key stakeholders. These states are leading efforts in these areas and provide key lessons about how to coordinate across health care and corrections and the potential of such initiatives to better link individuals to the physical and behavioral services they need. Each of the case study states is connecting individuals to coverage at multiple points within the justice system. The study states also connect individuals to care in the community as they are released from jail or prison. Stakeholders and data indicate that these approaches have increased coverage, facilitated access to care, and contributed to administrative efficiencies and state savings. However, more data and time are needed to examine the effects on health and criminal justice outcomes, including recidivism rates.

  • Puerto Rico: Datos Básicos

    Fact Sheet

    Puerto Rico: Datos Básicos provee una descripción general del las características demográficas, y estadísticas de salud y la economía. También se da alguna informacion del gobierno, reglas federales de Medicaid, y asuntos corrientes que estan afectando el territorio, incluyendo a Zika.

  • ACA Coverage and the Changing Labor Market: Voices from the Field

    Issue Brief

    This brief highlights voices from adult focus group participants with low and moderate incomes who gained Medicaid or Marketplace coverage following implementation of the ACA. It focuses on work, including work status, the new labor market, job benefits, and the role of ACA coverage for those with non-traditional jobs.

  • The Pennsylvania Health Care Landscape

    Fact Sheet

    The Affordable Care Act (ACA) went into full effect on January 1, 2014, ushering in health insurance reforms and new health coverage options in Pennsylvania and elsewhere across the country. Pennsylvania is experiencing changes to its health care delivery system as the state expands Medicaid, provides new coverage options through the federal health insurance marketplace, streamlines application and enrollment processes for coverage programs, and implements new health care delivery system and payment reforms. This fact sheet provides an overview of population health, health coverage, and the health care delivery system in Pennsylvania in the era of health reform.