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  • Summary of Key Changes to Medicare in 2010 Health Reform Law   

    Issue Brief

    Summary of Key Changes to Medicare in 2010 Health Reform Law . This brief provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects and other Medicare provisions in the law. It includes a timeline of key dates for implementing the Medicare-related provisions in the law.

  • Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…

  • State Financing of the Medicare Drug Benefit:  New Data on the “Clawback”

    Issue Brief

    State Financing of the Medicare Drug Benefit: New Data on the "Clawback" Beginning in 2006, states will be obligated to finance part of the new Medicare prescription drug benefit via a monthly "clawback" payment to the federal government. This issue update analyzes the latest data and provides an overview of the state financing of the Medicare drug benefit. Issue Brief (.pdf)

  • The Stability of Medicaid Coverage for Low-Income Dually Eligible Medicare Beneficiaries

    Report

    This report examines the stability of dual eligibility for the seven million Americans who rely on Medicaid to fill the gaps in their Medicare coverage and its implications for Medicare's new prescription drug benefits. The analysis focuses on the duration of dual eligibility, the rates of gain and loss of Medicaid coverage and sources of Medicare supplementation preceding and following periods of Medicaid enrollment. The paper analyzes data from the Medicare Current Beneficiaries Surveys from…

  • Pulling it Together: Duals: The National Health Reform Experiment We Should Be talking More About

    From Drew Altman

    The Center for Medicare & Medicaid Services (CMS) and 26 states are moving to launch a large scale managed care demonstration project potentially involving millions of the poorest, sickest, most expensive Medicare and Medicaid beneficiaries, the so-called dual eligibles. The experiment is getting more and more attention from policy experts, but with controversial issues like the survival of the Affordable Care Act and converting Medicare to a premium support program grabbing the limelight, it has…

  • A Prescription Drug Benefit in Medicare: Implications for Medicaid and Low-Income Medicare Beneficiaries

    Issue Brief

    The Senate and House of Representatives each approved legislation in June of 2003 that would establish outpatient prescription drug coverage for Medicare beneficiaries as part of Medicare program reform. Among the key differences in the House and Senate bills that still must be addressed are the treatment of Medicaid beneficiaries and the structure of low-income subsidy programs. The way in which these issues are resolved will have major implications for Medicaid beneficiaries, other low-income individuals,…

  • The New Medicare Drug Benefit:  Potential Effects of Pharmacy Management Tools on Access to Medications

    Issue Brief

    The New Medicare Drug Benefit: Potential Effects of Pharmacy Management Tools on Access to Medications This report describes the pharmacy benefit management tools that will be available to private plans administering the new Medicare drug benefit, including formularies, the definition of categories and classes, and cost sharing requirements. The authors conclude that substantial flexibility given to plans to design management tools could have significant implications for beneficiaries’ access to needed medications and out-of-pocket spending. Issue…

  • Help with Medicare Premium and Cost-Sharing Assistance Varies by State

    Issue Brief

    This data note provides an overview of programs that help beneficiaries with modest incomes with their Medicare costs, including the Medicare Savings Programs and the Part D Low-Income Subsidy, and highlights findings from corresponding state-level profiles of eligibility and enrollment.