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  • Medicaid Managed Care Plans and Access to Care: Results from the Kaiser Family Foundation 2017 Survey of Medicaid Managed Care Plans

    Report

    Managed care organizations (MCOs) cover nearly two-thirds of all Medicaid beneficiaries nationwide, making managed care the nation’s dominant delivery system for Medicaid enrollees. As the entities responsible for providing comprehensive Medicaid benefits to enrollees by contracting with providers, managed care plans play a critical role in shaping access to care for Medicaid enrollees. Many plan actions are dictated by state policy or contracting requirements; however, plans also have some flexibility to design payment and delivery…

  • States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019

    Report

    This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia. This report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019 (which began for most states on July 1, 2018). Key areas covered include changes in…

  • When Minutes Matter, What Is AI’s Role? 

    Podcast

    When minutes matter for a patient’s care, what is AI’s role in clinical practice? Elad Walach, co-founder and CEO of Aidoc — a company with a comprehensive AI health care platform that analyzes real-time images and flags time-sensitive findings — shares his perspective on AI’s transformative power in dodging diagnostic error, improving access to care, and ensuring care quality in busy clinical settings.

  • AI: As Much Peril As Promise?

    Podcast

    What does AI mean for patients in bed and doctors at the bedside? Host Chip Kahn and guest Dr. Robert Wachter, Chair of the Department of Medicine at the University of California, San Francisco, discuss whether AI will produce a different kind of doctor in the future — a “clinician curator rather than a clinician-diagnostician.” The answer could define the future of medicine and the doctor-patient relationship.

  • New Orleans Five Years After the Storm: A New Disaster Amid Recovery

    Poll Finding

    This comprehensive survey of the experiences of New Orleans residents is the third in a series conducted by the Kaiser Family Foundation since 2005.  Five years after Hurricane Katrina, an increasing majority of the city’s residents says the rebuilding process is going well, but substantial majorities still report that the city has not recovered and feel the nation has forgotten them.  The survey also finds the scope and immediacy of the Gulf oil spill weighing heavily on…

  • Awaiting New Medicaid Managed Care Rules: Key Issues to Watch

    Issue Brief

    More than half of all Medicaid beneficiaries now receive their services in risk-based managed care plans, and states’ use of managed care is expanding. States operate their own Medicaid managed care programs within federal rules and requirements. The federal regulations were last updated in 2002 and a new proposed rule is expected in Spring 2015. This brief identifies key issues in the regulation and discusses how CMS might address them.

  • Medi-Cal Managed Care: An Overview and Key Issues

    Issue Brief

    California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation, insuring almost one-third of Californians. For several decades, Medi-Cal has been transitioning from a fee-for-service (FFS) system to risk-based managed care, and more than three-quarters of all Medi-Cal beneficiaries, including low-income children, adults, seniors, and people with disabilities, are now enrolled in managed care plans. As other state Medicaid programs increase their reliance on risk-based managed care, a review of California’s transition…

  • AI at Scale: Does It Deliver?

    Podcast

    How is AI applied to clinical care and hospital operations across a real health system at full scale? Chip Kahn talks to Dr. Michael Schlosser, Senior Vice President and Chief Transformation Officer at HCA Healthcare, about how AI is developed for everyday use, starting with careful testing and customization, with clinicians and nurses engaged from the very beginning as end users.

  • 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.