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A Primer on Dually Eligible Beneficiaries

The nine million dually eligible beneficiaries are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of Medicare and Medicaid spending. Because they often have complex medical and long-term care needs, and must navigate both Medicaid and…

Managing Costs and Improving Care: Team-based Care of the Chronically Ill

Treating those with multiple chronic conditions, including the elderly and disabled populations, accounts for 30 percent of total U.S. health care spending. Half of this amount is spent by Medicare and Medicaid on behalf of beneficiaries eligible for both programs. This briefing, cosponsored by the Alliance for Health Reform and…

Quality Care for Less Money: Can Regional Successes Go National?

On February 15, the Kaiser Family Foundation hosted an event featuring a PBS documentary with former Washington Post correspondent T.R. Reid – U.S. Health Care: The Good News – which explores efforts to provide low-cost, quality health care in the U.S. The film looks at variations in health spending across…

State Options That Expand Access to Medicaid Home and Community-Based Services

This background paper examines various aspects of the Medicaid program that can expand access to home and community-based services (HCBS) and rebalance long-term care spending in favor of HCBS. As a result of the long-standing requirement that states cover facility-based care, the majority of Medicaid long-term care (LTC) expenditures historically…

Data Analytics in Medicaid: Spotlight on Colorado’s Accountable Care Collaborative

An integral component of Colorado Medicaid’s coordinated care initiative, the Accountable Care Collaborative, is the Statewide Data Analytics Contractor (SDAC), which is responsible for providing actionable data through a web portal to primary care providers and regional care collaborative organizations. The metrics and tools the SDAC provides undergird the effort to drive improvement in care management and individual and community health, and support the accountable care model.

An Overview of Delivery System Reform Incentive Payment (DSRIP) Waivers

This brief will examine similarities and difference across key elements of DSRIP waivers. The states included in this analysis are: California, Texas, Kansas, New Jersey, Massachusetts, and New York. The key elements of DSRIP initiatives that will be explored in this analysis include: the goals and objectives of the DSRIP initiative; eligible providers; projects and organization; allocation of funds; data collection and evaluation/reporting; and financing of DSRIP waivers.

Medicare Delivery System Reform: The Evidence Link

The Kaiser Family Foundation’s Evidence Link is an interactive resource that pulls together the latest available evidence on Medicare payment and delivery system reform models, with an initial focus on accountable care organization (ACO), medical home, and bundled payment models. Through FAQs and side-by-side comparison tables, the Evidence Link synthesizes the most up-to-date information on savings and quality results, and describes key design features of each Medicare model, such as how providers are paid, the number of beneficiaries receiving care under each model, where models are being tested, and timelines for evaluations.

8 FAQs: Medicare Medical Home Models

Medical homes are typically team-based primary care practices that provide the majority of their patients’ health care needs either directly, or through coordination with other providers. These FAQs describe the medical home models in Medicare, and answer questions pertaining to spending and quality results, where models are located, and how many beneficiaries are involved. These Medicare medical home FAQs are part of the Medicare Delivery System Reform Evidence Link.