10 Things to Know About Medicaid Managed Care
Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
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Our updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
The new health reform law contains a number of changes in the way health care is paid for, particularly in public programs such as Medicare and Medicaid. The Alliance for Health Reform and The Commonwealth Fund sponsored a May 10 briefing which explored topics such as how some health care providers will be paid differently under reform, what effect this might have on payments across the health care system, and how providers are reacting. For…
The Federal Government will Fund the Vast Majority of Medicaid Expansion Costs Download
This report provides an overview of Medicaid financing and Medicaid spending and enrollment growth with a focus on state fiscal years 2015 and 2016 (FY 2015 and FY 2016.) Findings are based on interviews and data provided by state Medicaid directors as part of the 15th annual survey of Medicaid directors in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured (KCMU) survey and Health Management…
This Health Policy 101 chapter explores the performance of the U.S. health system on a number of cost, outcomes, and quality measures by comparing it with those in similarly large and wealthy OECD nations. It highlights that despite significant spending, Americans have shorter life expectancies and encounter more barriers to health care, influenced by both the health system's structure and broader socioeconomic factors.
CMS is taking a new approach to fraud that will rely more heavily on options to pause or withhold significant amounts of federal funding in cases of potential fraud, which could have broad implications for states and enrollees. This issue brief explains the new approach.
Section 1115 Medicaid demonstration waivers offer states an avenue to test new approaches in Medicaid that differ from what is required by federal statute. Nearly all states have at least one active Section 1115 waiver and some states have multiple 1115 waivers. This brief explains what Section 1115 waivers are and how they are used, summarizes key waiver requirements, and outlines the application and approval process.
The House Committee on Appropriations approved the FY 2026 National Security, Department of State, and Related Programs (NSRP) appropriations bill and accompanying report on July 23, 2025. The NSRP bill includes funding for U.S. global health programs at the State Department through the Global Health Programs (GHP) account, which represents the bulk of global health assistance. Global health funding in the bill totaled $9.5 billion, a decrease of $512 million (-5%) below the FY 2025…
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. CMS is presently reviewing the states' proposals to determine which will be implemented. This background paper examines the contents of the 26 states'…
This KFF brief provides key facts about U.S. funding for global health, including the range of efforts the U.S. supports, U.S. agencies/departments involved in global health activities, funding trends, and more.
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