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Virginia is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.
In a new policy insight, the Kaiser Family Foundation’s Tricia Neuman and Juliette Cubanski examine a 1990 federal law that ensures that people age 65 and older are able to buy a Medigap policy when they sign up for Medicare, but denies younger Medicare beneficiaries with disabilities the same right unless they live in a state that requires it.
On May 18, 2016, the Department of Health and Human Services (HHS) published a final rule to implement Section 1557 of the Affordable Care Act (ACA), which prohibits discrimination in health coverage and care based on race, color, national origin, age or disability, and, for the first time sex. This Issue Brief provides a technical summary of Section 1557 and the final rule and highlights new protections and provisions included in the law and rule.…
This issue brief examines the role of Medicare for people under age 65 with disabilities, including how this group qualifies for Medicare, the characteristics of people under age 65 with disabilities compared to those age 65 or older, and how sources of supplemental coverage and prescription drug coverage, spending and use of services, and access to care differ for Medicare beneficiaries under age 65 with disabilities and older beneficiaries.
This report presents findings from a state survey about Medicaid Section 1115 capitated managed long-term care services and supports waiver enrollment, spending, and program policies for seniors and people with disabilities as of 2015.
The Trump Administration and new Congress have indicated that they will seek to cap Medicaid financing through a block grant or per capita cap, reduce federal funding for the program, and offer states increased flexibility to manage their programs within this more limited financing structure. The size of the federal reductions as well as which federal program standards would remain in place and what increased flexibility might be provided to states under such proposals would…
June 2014 marks the 15th anniversary of the United States Supreme Court’s landmark civil rights decision in Olmstead v. L.C., finding that the unjustified institutionalization of people with disabilities is illegal discrimination. This issue brief examines the legacy of Olmstead, with an emphasis on legal case developments and policy trends emerging in the last five years and the related contributions of the Medicaid program.
This report examines the structure and impact of Medicaid’s role in long-term care. Based on a roundtable discussion of policy makers and experts and drawn from a body of health services research, the report highlights policy challenges facing the Medicaid program today and identifies issues in providing long-term care going forward. By gathering evidence to address key policy issues, such as integrating services, benefit design, quality monitoring and financing, the report can serve as a…
These three reports examine the relatively high use of hospital and other Medicare-covered services and the associated costs of medical care for Medicare beneficiaries who live in nursing homes and other long-term-care facilities. They also explore the potential for delivery system reforms to improve quality and reduce costs. Medicare Spending and Use of Medical Services for Beneficiaries in Nursing Homes and Other Long-Term Care Facilities: A Potential for Achieving Medicare Savings and Improving the Quality…
This chartbook provides the most recent and reliable data available about the Medicare program and the 47 million seniors and younger people with disabilities who get health insurance coverage through the program. Topics covered include: Medicare beneficiaries; the program's benefits, utilization, and access to care; prescription drugs; the Medicare Advantage program; the role of Medicaid for Medicare beneficiaries; supplemental insurance coverage; out-of-pocket spending; and Medicare spending and financing. Printable Chartbook (.pdf)
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