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  • Washington’s Managed FFS Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013. Washington’s managed FFS demonstration uses Medicaid health home services to coordinate care for high risk/high cost dual eligible beneficiaries with chronic conditions. This policy brief summarizes key aspects of the…

  • Views of the New Medicare Drug Law – Chartpack By Income Group

    Report

    This comprehensive survey of people on Medicare, conducted in June and July 2004, assesses their attitudes toward the new Medicare drug law. This chartpack, issued in September 2004, presents additional analysis on the survey data, looking at key findings broken down by income group. Chartpack (.pdf)

  • Affordable Care Act Provisions Relating to the Care of Dually Eligible Medicare and Medicaid Beneficiaries

    Issue Brief

    This issue brief identifies the major provisions in the Patient Protection and Affordable Care Act (ACA) that are designed to improve care and streamline service delivery for dual eligibles, the millions of low-income seniors and younger persons with disabilities who are enrolled in both the Medicaid and Medicare programs. Dual eligibles are among the sickest and poorest individuals covered by either the Medicaid or Medicare programs; they comprise only 15 percent of total Medicaid enrollment…

  • Grievance and Appeals Procedures: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Sara Rosenbaum, J.D., Director of the Center for Health Services Research and Policy at George Washington University, examines the procedures for resolving beneficiaries' grievances and appeals under the new Medicare drug benefit. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • The Connection Between Social Security Disability Benefits and Health Coverage Through Medicaid and Medicare

    Issue Brief

    This analysis examines who was eligible for Medicare and/or Medicaid between 2002 and 2022 because they received disability benefits from one of the country's Social Security disability programs, Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI). Many who receive SSDI and SSI qualify for both Medicare and Medicaid, known as dual-eligible individuals.

  • Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS

    Issue Brief

    This brief summarizes 15 states' preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those…

  • Firm Perspectives on the Medicare Advantage Market

    Issue Brief

    Based on interviews with senior executives at 14 large firms, the issue brief finds that insurers anticipate continuing to offer Medicare Advantage plans in 2012, in part because of a Medicare demonstration project that will award bonus payments to plans based on their quality standards. A companion issue brief examines trends in Medicare Advantage enrollment in 2011. The analysis was conducted by researchers at Mathematica Policy Research, Inc. and the Kaiser Family Foundation. Issue Brief…