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As federal and state governments advance efforts to better coordinate care and reduce costs for people dually eligible for both Medicare and Medicaid benefits, this brief examines how insurers now serving these markets view the opportunities and challenges, including a look at Medicare Advantage Special Needs Plans.
On March 23, 2010, the Affordable Care Act (ACA) was signed into law. Although the date for full implementation of most provisions of the law is January 1, 2014, the ACA has already led to progress toward expanded coverage of the uninsured; improved access and better care delivery models; broader access to community-based long-term care; and more integrated care and financing for beneficiaries who are dually eligible for Medicare and Medicaid. The brief provides an…
Medicaid Has Many Vital Roles in our Health Care System Download
Enrollment of Dual Eligible Beneficiaries, FFY 2009 Download Source Kaiser Commission on Medicaid and the Uninsured and Urban Institute estimates based on data from FFY 2009 MSIS and CMS-64 reports, 2012. 2008 MSIS data was used for PA, UT, and WI, because 2009 data were unavailable.
Dual Eligible Beneficiaries as a Percent of Medicare and Medicaid Enrollment and Spending, 2008 Download Source Medicare spending and enrollment estimates from Kaiser Family Foundation analysis of the 2008 CMS Medicare Current Beneficiary Survey Cost and Use File; Medicaid spending and enrollment estimates from Kaiser Commission on Medicaid and the Uninsured and Urban Institute analysis of data from FY 2008 MSIS and CMS Form 64
This slide shows how many people are covered by both Medicare and Medicaid.
This paper contains short profiles four Medicaid beneficiaries who have been helped by Money Follows the Person demonstration programs in Michigan and Washington state. REPORT Download
The Centers for Medicare and Medicaid Services (CMS) has finalized memoranda of understanding (MOUs) with Massachusetts and Ohio to test a capitated financial alignment model to integrate care and align financing for people who are dually eligible for Medicare and Medicaid in 2013. CMS also has signed an MOU with Washington to test a managed fee-for-service model. These three year demonstrations will introduce changes in the care delivery systems through which beneficiaries presently receive services…
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. It provides updated enrollment and spending figures on the medically needy using data through federal fiscal year 2009, and explains how individuals become eligible for the program and key considerations for policy discussions. Brief (.pdf)
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. The idea is to attract new physicians to Medicaid and provide greater support for physicians who already participate. As a result, Medicaid fees paid to certain physicians for primary…
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