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  • Medicare and The Under-65 Disabled

    Fact Sheet

    As part of The Faces of Medicare, a collection of fact sheets profiling the characteristics and health needs of different groups of Medicare beneficiaries, Medicare and the Under-65 Disabled highlights key information about Medicare's under-65 disabled, whose disproportionately high rates of health and cognitive problems are compounded by low incomes. Fact Sheet

  • Medicare State Profiles: State and Regional Data on Medicare and the Population it Serves

    Report

    Although Medicare is a national program, there are substantial variations across states and regions in terms of beneficiary characteristics, health needs, and utilization of Medicare-covered services. Likewise, there are also considerable differences in Medicare spending and the emergence of Medicare managed care. In a single resource document, , presents state-by-state demographic data on the Medicare population, along with information on health service utilization, spending, and Medicare HMO penetration. It also provides regional data on the…

  • Medicaid’s Disabled Population and Managed Care

    Fact Sheet

    Medicaid's Disabled Population and Managed Care This fact sheet highlights the key facts about the Medicaid managed care programs that serve persons with disabilities. It describes the Medicaid disabled population and the role managed care plays in serving them. It also provides information on enrollment in managed care, program features, and issues such as quality assurance, rate setting, and benefits. Fact Sheet

  • A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community

    Issue Brief

    The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from several states suggests that providing care in the community can be less expensive than providing institutional care. The Affordable Care Act (ACA) provides incentives for…

  • Health Care Use and Chronic Conditions Among Childless Adult Medicaid Enrollees in Arizona

    Issue Brief

    Under the Affordable Care Act (ACA), beginning in 2014, Medicaid eligibility will expand to 133% of the federal poverty level for nearly all individuals. Arizona is one of the few states that already cover adults without dependent children in Medicaid through a longstanding Section 1115 waiver. This report, based on 2007 Medicaid claims data for adult Medicaid enrollees in Arizona, provides an analysis of health care utilization and health conditions for childless adults and compares…

  • Rethinking Medicaid’s Financing Role for Medicare Enrollees

    Issue Brief

    This issue brief examines coverage of the nearly 9 million "dual eligible" beneficiaries, the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. It explores the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, including having the federal government pick up the full cost of Medicare premiums, cost-sharing and gaps in Medicare-covered services and long-term care services for this population.…

  • Florida Medicaid Reform Waiver: Early Findings and Current Status

    Issue Brief

    Florida Medicaid Reform Waiver: Early Findings and Current Status This policy brief provides an overview of the Florida Medicaid reform and a summary of available research findings to date from various evaluators of the program. It was issued at the same time as a separate Health Affairs article highlighting findings from Kaiser Family Foundation's 2006-2007 Survey of Florida Medicaid Beneficiaries. The Foundation, in collaboration with the Urban Institute and the University of Florida, is conducting…

  • State Options That Expand Access to Medicaid Home and Community-Based Services

    Report

    This background paper examines various aspects of the Medicaid program that can expand access to home and community-based services (HCBS) and rebalance long-term care spending in favor of HCBS. As a result of the long-standing requirement that states cover facility-based care, the majority of Medicaid long-term care (LTC) expenditures historically have been for institutional, rather than home and community-based, services. Over the past two decades, major efforts have been undertaken by states and the Centers…

  • Beyond Cash and Counseling: The Second Generation of Individual Budget-Based Community Long-Term Care Programs for the Elderly

    Report

    States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. Beginning in January 2007, a new provision in the Deficit Reduction Act of 2005 (DRA) allows states to offer an individual budget option for an expanded range of home- and community-based services in their Medicaid state plans…