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  • How Are Hospitals Faring Under the Affordable Care Act? Early Experiences from Ascension Health

    Issue Brief

    Expanded health insurance coverage through the Affordable Care Act (ACA) is having a major impact on many of the nation’s hospitals through increases in the demand for care, increased patient revenues, and lower uncompensated care costs for the uninsured. This report examines the early experiences with the ACA by Ascension Health, the delivery subsidiary of the nation’s largest not-for-profit health system, Ascension. It finds that, overall, Ascension hospitals in Medicaid expansion states saw increased Medicaid discharges, increased Medicaid revenue, and decreased cost of care for the poor, while hospitals in non-expansion states saw a very small increase in Medicaid discharges, a decline in Medicaid revenue, and growth in cost of care to the poor.

  • Strategies to Reduce Medicaid Spending: Findings from a Literature Review

    Issue Brief

    This issue brief considers the feasibility of realizing substantial Medicaid cost savings through strategies aimed at improving delivery system and administrative efficiency. We review the literature about the potential for Medicaid cost savings from four strategies related to acute care services: (1) premiums, cost-sharing, and enrollee wellness incentives, (2) complex care management, (3) patient-centered medical homes, and (4) alternative payment models, and another four strategies related to long-term services and supports: (5) tightening financial eligibility rules for long-term care services, (6) promoting private long-term care insurance, (7) expanding home and community-based services (HCBS), and (8) increasing use of managed long-term services and supports.

  • Using Medicaid to Wrap Around Private Insurance: Key Questions to Consider

    Issue Brief

    This issue brief raises three key questions for consideration if using Medicaid to wrap around private coverage is going to be considered as an alternative to the ACA's Medicaid expansion under the BCRA. We draw on existing information about state Medicaid premium assistance programs to date, the administrative complexity involved, and the financing implications of premium assistance programs.

  • U.S. Funding for International Maternal & Child Health

    Issue Brief

    The U.S. government has a long history of supporting international maternal and child health (MCH) efforts, including global immunization activities, and is the largest donor government to MCH activities in the world. This brief provides an overview of U.S. funding for MCH, including trends in bilateral and multilateral funding and top country recipients of U.S. funding, and places the U.S. within the larger context of overall donor support for the sector.

  • U.S. Funding for International Family Planning & Reproductive Health

    Issue Brief

    The U.S. government has supported international family planning and reproductive health (FP/RH) efforts for 50 years and is one of the largest donors to FP/RH in the world. This brief provides an overview of U.S. funding for FP/RH, including trends in bilateral and multilateral funding and top country recipients of U.S. funding, and places the U.S. within the larger context of overall donor support for the sector.