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.
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Bundled payment models are a way for Medicare to establish a total budget for all services provided to a beneficiary throughout an episode of care. These FAQs describe the different types of Medicare bundled payment models, and answer questions pertaining to spending and quality results, where models are located, and how many beneficiaries are involved. These Medicare bundled payment FAQs are part of the Medicare Delivery System Reform 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.
This tutorial walks users through the Medicare Delivery System Reform Evidence Link, including its FAQs and side-by-side comparison tables on Medicare accountable care organization (ACO), medical home, and bundled payment models.
Keep current with Medicare Payment and Delivery System Reform news, including recently-proposed rules, newly-released spending and quality results, and announcements on model changes.
This interactive provides state-by-state data on Medicaid delivery system and payment reform initiatives. Users can track state Medicaid managed care, patient-centered medical home (PCMH), Health Home, Accountable Care Organization (ACO), and Delivery System Reform Incentive Payment (DSRIP) waiver activity.
Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018
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 conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report examines the reforms, policy changes, and initiatives that occurred in FY 2017 and those adopted for implementation for FY 2018 (which began for most states on July 1, 2017). Key areas covered include changes in eligibility and enrollment, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits (including prescription drug policies), and opioid harm reduction strategies.
This list of Frequently Asked Questions (FAQs) about Medicare Open Enrollment covers a range of topics related to Medicare enrollment, Medicare Advantage, Part D, Medigap, employer/retiree coverage, Medicaid and other low-income assistance, Medicare and the Marketplaces, and more.
Most states today rely heavily on risk-based managed care organizations (MCOs) to serve Medicaid beneficiaries. This Data Note discusses the current role of managed care in Medicaid and examines differences in managed care growth between states that expanded Medicaid to low-income adults under the Affordable Care Act (ACA) and states that did not expand Medicaid.
This Issue Brief describes the Medicare Hospital Readmission Reduction Program (HRRP), which penalizes hospitals that have relatively higher readmission rates, analyzes the impact of this program on Medicare patients and hospitals, and discusses several issues that have been raised regarding its implementation.