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  • Medicaid: What to Watch in 2019 from the Administration, Congress, and the States

    Issue Brief

    Medicaid, the provider of health insurance coverage for about one in five Americans and the largest payer for long-term care services in the community and nursing homes, continues to be a key part of health policy debates at the federal and state level. Important Medicaid issues to watch in 2019 include Medicaid expansion developments amid ongoing litigation about the ACA’s constitutionality as well as Medicaid demonstration waiver activities, including those focused on work requirements and…

  • Can AI Break the “Measurement Paradigm?”

    Podcast

    How do we know if AI use in health care actually makes patients better? Chip talks with Dr. David Bates — a veteran physician leader at Mass General Brigham and the Brigham and Women's Hospital and Co-director of the Center for Artificial Intelligence and Bioinformatics Learning Systems — about measuring patient outcomes reliably and in real time to create a strong foundation for everything else in health care administration — clinical deployment, payment reform, consumer…

  • AI: Show Me the Outcomes

    Podcast

    Chip talks with Dr. Toyin Ajayi, co-founder and CEO of Cityblock Health, which delivers value-based care to more than 100,000 Medicaid and dual-eligible members across ten states, many of them people of color managing chronic conditions. Ajayi makes a pointed case: Roughly 60 percent of health care AI investment goes to billing, coding, and risk adjustment — making sure someone gets paid — while only a fraction goes to delivering care. If we continue to…

  • Health Care in Puerto Rico and the U.S. Virgin Islands: A Six-Month Check-Up After the Storms (Report)

    Issue Brief

    Puerto Rico and the U.S. Virgin Islands suffered significant damage to their infrastructure and health care systems from Hurricanes Irma and Maria in September 2017. Drawing on interviews with residents and key stakeholders as well as public reports, this brief provides an overview of the status of the recovery efforts six months after the storms, with a focus on the health care systems.

  • An Overview of Medicare

    Issue Brief

    This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with long-term disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries' out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.

  • Medicaid Reforms to Expand Coverage, Control Costs and Improve Care: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2015 and 2016

    Report

    This report provides an in depth examination of the changes taking place in state Medicaid programs across the country. The findings in this report are drawn from the 15th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA), with the support of the National Association of Medicaid Directors. This report highlights policy changes implemented…

  • What Might a Repeal of the Affordable Care Act Mean for Medicare?

    News Release

    As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a new Kaiser Family Foundation brief. A full repeal of the ACA would undo all of the law’s changes to Medicare and would increase Medicare spending,…

  • AI: Rewiring the Machine

    Podcast

    In a conversation focused on the technology underlying AI in health care, Chip is joined by Seema Verma, former administrator of the Centers for Medicare & Medicaid Services (CMS), and now Executive Vice President and General Manager at Oracle Health and Life Sciences, the second largest electronic health records (EHR) platform in the U.S. Seema shares her insights on the evolution of EHRs and why it’s necessary to redesign these systems to better integrate AI capabilities and improve the quality of care.

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

    Issue Brief

    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.

  • The AI Arms Race in Administrative Health Care

    Podcast

    Caroline Pearson, executive director of the Peterson Health Technology Institute (PHTI) and the Peterson Center on Healthcare, joins Chip to discuss who really benefits as AI moves into health care's back office. A quiet arms race is underway — providers deploying AI to code, bill, and capture revenue and insurers deploying it right back to review, deny, and hold the line. The open question is whether any of this lowers what the country actually spends…