10 Things to Know About Medicaid Managed Care
Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
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As Pandemic-Era Policies End, Medicaid Programs Focus on Enrollee Access and Reducing Health Disparities Amid Future Uncertainties
FeatureThis report highlights certain policies in place in state Medicaid programs in FY 2024 and policy changes implemented or planned for FY 2025, which began on July 1, 2024 for most states.
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North Carolina’s Effort to Relieve Medical Debt
Policy WatchThis policy watch examines the burden of medical debt in North Carolina and the state’s new plan to leverage the Medicaid program to provide debt relief and support access to care for low- and middle-income North Carolinians.
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What You Need to Know About Medicaid Managed Care, Amid the New Federal Rules
News ReleaseManaged care is the most common delivery system for Medicaid. Most states (42, including DC) use comprehensive managed care plans to provide care to at least some of their Medicaid enrollees, according to KFF’s updated explainer.
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Medicaid Authorities and Options to Address Social Determinants of Health
Issue BriefSocial determinants of health (SDOH) are the conditions in which people are born, grow, live, work and age. While there are limits, states can use Medicaid – which, by design, serves a primarily low-income population with greater social needs – to address social determinants of health. This brief outlines the range of Medicaid authorities and flexibilities that can be used to add benefits and design programs to address the social determinants of health.
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Medicaid Managed Care Network Adequacy & Access: Current Standards and Proposed Changes
Issue BriefThis brief describes current network adequacy and availability standards for Medicaid managed care plans, presents related findings from KFF’s 22nd annual Medicaid budget survey, and summarizes proposed changes to network adequacy and access rules in the Managed Care NPRM.
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Mapping Medicaid Managed Care Models & Delivery System and Payment Reform
Issue BriefDelivery system and payment reform are dynamic and ever-evolving policy areas of state Medicaid programs; virtually every state has initiatives underway. This interactive is designed to provide users with an environmental scan of the activity.
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State Delivery System and Payment Strategies Aimed at Improving Outcomes and Lowering Costs in Medicaid
Issue BriefState 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 and payment reform initiatives.
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Delivery System Reform Incentive Payment Program (DSRIP) Waivers and Uncompensated Care Pools in Place
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Housing Affordability, Adequacy, and Access to the Internet in Homes of Medicaid Enrollees
Issue BriefThe COVID-19 pandemic and the ensuing economic disruption have drawn more attention to longstanding issues related to housing and internet access and how these issues can impact health. As the primary source of health insurance for low-income populations, Medicaid covers a considerable share of people living in homes that are unaffordable, inadequate, or have limited access to the internet. This brief examines housing adequacy, affordability, and internet access within the homes of Medicaid enrollees using data from the 2019 American Community Survey (prior to the COVID-19 pandemic) and assesses the limited role that Medicaid can play in helping to address these challenges.