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  • CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes

    Issue Brief

    On November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in areas including network adequacy, beneficiary protections, quality oversight, and rates and payment.

  • 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.

  • Promotional graphic for KFF's The Business of Health Podcast

    Health Care’s AI Disruption, Ready or Not 

    Podcast

    The AI revolution is already here — but what does it mean for patients, clinicians, and health care industry leaders? Eric Larsen, veteran health care strategist and longtime advisor to CEOs across the industry, joins host Chip Kahn for a discussion about why the U.S. health care industry is uniquely exposed to AI-driven disruption and the implications for patients, clinicians, and the health care workforce. Listen to Larsen's take on "the most consequential technology humanity’s…

  • What AI Can Do — And What It Can’t 

    Podcast

    The data is good enough, the technology is getting better, the computing is becoming more available, and the use cases are getting clearer—but is AI truly a revolutionary technological advancement yet for health care? With a 30-year perspective on what digital technology has done and failed to do in health care, Dr. John Halamka, President of the Mayo Clinic Platform, joins Chip in discussing whether AI is actually disruptive or another wave of incremental change.

  • When Minutes Matter, What Is AI’s Role? 

    Podcast

    When minutes matter for a patient’s care, what is AI’s role in clinical practice? Elad Walach, co-founder and CEO of Aidoc — a company with a comprehensive AI health care platform that analyzes real-time images and flags time-sensitive findings — shares his perspective on AI’s transformative power in dodging diagnostic error, improving access to care, and ensuring care quality in busy clinical settings.

  • Safety-Net Emergency Departments: A Look at Current Experiences and Challenges

    Issue Brief

    Safety-net hospital emergency departments (EDs) are an important part of our health care system, especially, but not only, for the uninsured and others with low income. With multiple major changes unfolding in our system today, including the development of new models of health care delivery, payment reforms, expanded insurance coverage, and increasing demand for primary care access, safety-net EDs are a sort of crucible in which these shifts and transitions can be seen playing out.…

  • Medicare Spending Peaks at Age 96

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of a Kaiser finding: per capita Medicare spending peaks at age 96, and the main reason is not end-of-life care.

  • 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.