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This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs.
The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of these models.
Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs.
This brief highlights data from a survey of coverage of 42 recommended preventive services for adults in Medicaid fee-for-service programs as of October 2010. Medicaid programs must cover preventive services for children as part of the Early Periodic Screening, Diagnosis and Treatment (EPSDT) benefit, but generally are not required to cover such services for adults.
This brief profiles four states that were the first to receive federal approval to take up a state option under the Affordable Care Act to implement health homes for Medicaid beneficiaries with chronic conditions.
As state and federal policymakers move to develop and test integrated care models for people dually eligible for Medicare and Medicaid, two new Kaiser Family Foundation articles in the June 2012 issue of Health Affairs highlight the diverse needs and challenges facing these 9 million beneficiaries, describe their current care arrangements, and raise issues to…
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 brief summarizes and examines the implications of recent Section 1115 Medicaid waiver activity. Section 1115 waivers provide states flexibility to test new approaches in Medicaid that differ from federal program rules and can have significant impacts for beneficiaries, providers, and states.
This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs.
Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid.
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