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This brief examines Medicaid's medically needy program, which gives states the option to extend Medicaid eligibility to those with high medical expenses whose income exceeds the maximum threshold, but who would otherwise qualify.
To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014.
This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid.
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.
These Foundation resources shed light on how the ongoing national debate about deficit reduction may affect Medicare, Medicaid and other health-care programs.
With pressure mounting to slow the growth in federal health care spending, policymakers are exploring ways to reform the way care is delivered to the 9 million low-income Medicare beneficiaries who also receive Medicaid – a group that on average is sicker and frailer than other Medicare beneficiaries, and therefore receive significantly more care at…
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.
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.
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