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  • The State Innovation Models (SIM) Program: An Overview

    Fact Sheet

    This fact sheet provides an overview of the Center for Medicare and Medicaid Innovation (Innovation Center)'s State Innovation Models (SIM) initiative. It focuses on the delivery system and payment approaches that Model Testing states are taking and discusses what SIM means for Medicaid. Six states – Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont -- received Model Testing awards to implement and test their Innovation Plans over 42 months.

  • At CMS, the Mission Is Broader Than Medicare and Medicaid

    From Drew Altman

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses whether the Centers for Medicare and Medicaid Services' broad new responsibilities implementing the Affordable Care Act and a more proactive approach to Medicare payment signals that it’s time for (another) name change.

  • At CMS, the Mission Is Broader Than Medicare and Medicaid

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman discusses whether the Centers for Medicare and Medicaid Services' broad new responsibilities implementing the Affordable Care Act and a more proactive approach to Medicare payment signals that it’s time for (another) name change. All previous columns by Drew Altman are available online.

  • 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.

  • Key Themes From Delivery System Reform Incentive Payment (DSRIP) Waivers in 4 States

    Issue Brief

    Building on an earlier brief that provided an overview of the components of DSRIP waivers, this analysis relied upon interviews with stakeholders to identify emerging trends and themes from DSRIP waivers in four states – California, Massachusetts, New York and Texas. It highlights that DSRIP waivers are spurring major change in relationships among providers; allowing providers to launch new initiatives aimed at improving care and reducing costs; and fostering a stronger focus on the social service needs of Medicaid beneficiaries. At the same time, the rapid pace of implementation is straining the ability of stakeholders to keep pace, including consumer advocates who are hard-pressed to track and respond to the DSRIP-driven changes that are fundamentally re-shaping the way that care is delivered to Medicaid beneficiaries.

  • Medicaid Moving Ahead in Uncertain Times: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2017 and 2018

    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 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.

  • Health Reform Hits Main Street

    Video

    This short cartoon explains the problems with the current health care system, the health reform changes that are happening now, and the big changes coming in 2014 as part of the Affordable Care Act (ACA). You can view the video on our site and it is also available on YouTube.

  • Managing Care Transitions in Medicaid: Spotlight on Community Care of North Carolina

    Issue Brief

    Community Care of North Carolina’s Transitional Care Program (TCP) provides robust transition planning for high-risk Medicaid inpatients to support sound transitions from the hospital back to the community and reduce emergency department use and readmissions. Integral elements of the TCP are hospital-based care managers who coordinate with care managers in medical home practices; centralized health information technology, and standard care management training and tools.

  • Medicaid Authorities and Options to Address Social Determinants of Health

    Issue Brief

    Social 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.

  • A Primer on Dually Eligible Beneficiaries

    Event Date:
    Event

    The nine million dually eligible beneficiaries are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of Medicare and Medicaid spending.