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  • State Delivery System and Payment Strategies Aimed at Improving Outcomes and Lowering Costs in Medicaid

    Issue Brief

    State 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…

  • Leveraging Medicaid in a Multi-Payer Medical Home Program: Spotlight on Rhode Island’s Chronic Care Sustainability Initiative

    Issue Brief

    Rhode Island's Chronic Care Sustainability Initiative (CSI) is a multi-payer patient-centered medical home program in which the one Medicaid health plan and all commercial health plans in the state participate. Hallmarks of the initiative are engaged leadership, mandatory participation but participatory governance, a common contract used by all payers, and investments in health information technology and other support for practice transformation.

  • How Are Hospitals Faring Under the Affordable Care Act? Early Experiences from Ascension Health

    Issue Brief

    Expanded health insurance coverage through the Affordable Care Act (ACA) is having a major impact on many of the nation’s hospitals through increases in the demand for care, increased patient revenues, and lower uncompensated care costs for the uninsured. This report examines the early experiences with the ACA by Ascension Health, the delivery subsidiary of the nation’s largest not-for-profit health system, Ascension. It finds that, overall, Ascension hospitals in Medicaid expansion states saw increased Medicaid…

  • Medicaid at 50

    Report

    The Medicaid program, signed into law by President Lyndon B. Johnson on July 30, 1965, will reach its 50th anniversary this year, a historic milestone. This report reflects on Medicaid’s accomplishments and challenges and considers the issues on the horizon that will influence the course of this major health coverage and financing program moving forward.

  • Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS

    Issue Brief

    This brief summarizes 15 states' preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those…

  • Strategies in 4 Safety-Net Hospitals to Adapt to the ACA

    Issue Brief

    This brief examines four safety-net hospitals to learn how they were preparing for the full implementation of the Affordable Care Act (ACA), in order to gain additional insight into the strategies being used and challenges being faced among safety-net hospitals across the country.

  • Innovative Medicaid Initiatives to Improve Service Delivery and Quality of Care: A Look at Five State Initiatives

    Report

    A number of states have used the flexibility of the Medicaid program to develop innovative payment and delivery systems designed to coordinate and improve quality of care. This brief, based on site visits from November 2009 through March 2010, highlights care coordination and related efforts in five states: Alabama, Oklahoma, Oregon, Pennsylvania and Washington state. Such efforts by states to realign the provider payment and delivery systems are key to improving Medicaid and to successfully…

  • Quick Take: Medicaid: 3 Key Issues to Watch in 2013

    Fact Sheet

    2013 will be a historic year for Medicaid with the implementation of major provisions to expand coverage and streamline enrollment in the Affordable Care Act (ACA) less than a year away, a surge in activity around care delivery reforms that seek to improve care and potentially reduce costs, and the unfolding of fiscal developments at the state and federal level. Today, Medicaid provides health and long-term care coverage to more than 60 million low-income children,…