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  • Advancing Access to Medicaid Home and Community-Based Services: Key Issues Based on a Working Group Discussion with Medicaid Experts

    Issue Brief

    This brief highlights key strategies to address financing, program administration and community workforce challenges that key experts, federal and state officials and advocates believe must be overcome to expand access to home and community-based services (HCBS). Among the key ideas drawn from a working group discussion at the Foundation are the benefits of: • providing additional federal financing to states to provide Medicaid HCBS and to administer these benefits; • simplifying the process for states…

  • Health Affairs Article: Florida’s Medicaid Reform: Informed Consumer Choice?

    Report

    Health Affairs Article: Florida's Medicaid Reform: Informed Consumer Choice? Florida's Medicaid reform program aims to encourage consumer choice and market competition by giving health plans new authority to vary benefits and having enrollees choose among the different plans. However, about three in 10 enrollees were not aware that they needed to make this health plan choice and over half of those who were aware reported difficulty making a plan choice, according to a Health Affairs…

  • 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 of Care

    Report

    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 of Care This report documents the relatively high rates of hospital stays, emergency room visits and skilled nursing facility admissions among long-term care facility residents. It finds that Medicare per capita spending for Medicare beneficiaries living in nursing homes, assisted-living centers and other long-term care facilities, $14,538 in…

  • Papers on Issues For People With Medicare Raised By Proposed Drug Benefit Regulations

    Issue Brief

    Papers on Issues For People With Medicare Raised By Proposed Drug Benefit Regulations The Kaiser Family Foundation has commissioned a series of papers to explore key issues that may be of concern for Medicare beneficiaries as the new Medicare drug benefit is implemented. These papers focus on specific areas of potential concern for people with Medicare. In addition, the Foundation also has produced a timeline of upcoming important dates leading up to the implementation of…

  • Current and Emerging Issues in Medicaid Risk-Based Managed Care: Insights from an Expert Roundtable

    Issue Brief

    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. Managed care enrollment may grow more rapidly as states work with the Centers for Medicare & Medicare Services (CMS) to implement initiatives to better integrate Medicare and Medicaid benefits and care for dual eligibles. The Foundation’s Kaiser Commission on…

  • An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees

    Issue Brief

    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. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans that seek to integrate benefits and align financial incentives between the two programs. On January 25, 2012, CMS issued a memorandum providing additional guidance for…

  • Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues

    Fact Sheet

    Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with a focus on eligibility, benefits and cost sharing, care delivery and provider payment, long-term services and supports, and dual eligibles, as well as key issues…

  • Medicaid’s New “Health Home” Option

    Issue Brief

    This brief provides key information about the new option for state Medicaid programs to provide "health home" services for enrollees with chronic conditions. The option, established under the new health reform law, took effect on Jan. 1, 2011. Health homes are designed to facilitate access to and coordination of the full array of primary and acute physical health services, behavioral health care and long-term community-based services and supports. Brief (.pdf)

  • 10 Things About Long-Term Services and Supports (LTSS)

    Issue Brief

    Medicaid paid for more than half of the $415 billion that the US spent on long-term services and supports in 2022, most of which went to home and community-based services as well as to care in nursing homes and other institutional settings.

  • Prescription Drug Spending Under The MMA: Modeling The Impact On Out-of-Pocket Costs

    Event Date:
    Event

    This report projects the impact of the new Medicare drug benefit on out-of-pocket spending for people who enroll in 2006. The analysis is based on a model developed by the Actuarial Research Corporation for the Kaiser Family Foundation. The model generally conforms to the Congressional Budget Office’s assumptions and projections about Medicare drug benefit spending and participation rates for the new benefit and for the low-income subsidy. The report was released at a briefing in…