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  • Implications of the Expiration of Medicaid Long-Term Care Spousal Impoverishment Rules for Community Integration

    Issue Brief

    To financially qualify for Medicaid long-term services and supports (LTSS), an individual must have a low income and limited assets. In response to concerns that these rules could leave a spouse without adequate means of support when a married individual needs LTSS, Congress created the spousal impoverishment rules in 1988. Originally, these rules required states to protect a portion of a married couple’s income and assets to provide for the “community spouse’s” living expenses when…

  • Medicaid Program Integrity and Current Issues

    Issue Brief

    Medicaid is a large source of spending in both state and federal budgets, making program integrity efforts important to prevent waste, fraud, and abuse and ensure appropriate use of taxpayer dollars. This brief explains what program integrity is, recent efforts at the Centers for Medicare and Medicaid Services (CMS) to address program integrity, and current and emerging issues.

  • Medicaid and Children’s Health Insurance Program Provisions in the New Health Reform Law

    Issue Brief

    This brief compares the Medicaid and Children's Health Insurance Program provisions in the new health reform law with pre-reform law governing those programs. The analysis focuses on Medicaid coverage and financing changes; how Medicaid and CHIP will interface with a new health insurance exchange and other Medicaid benefits and access changes. Overall, the new law includes an individual requirement to obtain health insurance, a significant Medicaid expansion and subsidies to help low-income individuals buy coverage…

  • Chronic Disease and Co-Morbidity Among Dual Eligibles: Implications for Patterns of Medicaid and Medicare Service Use and Spending

    Report

    The health reform law contains provisions that aim to improve the delivery and coordination of services for persons enrolled in both Medicaid and Medicare, known as the dual eligibles. This population includes individuals with some of the most severely disabling chronic conditions. While the higher costs associated with services to dual eligibles is well-known, information on how spending is distributed across these programs is less understood. This study uses linked Medicare and Medicaid data to…

  • A Global Look at Public Perceptions of Health Problems, Priorities, and Donors: The Kaiser/Pew Global Health Survey

    Poll Finding

    This survey, conducted jointly by the Kaiser Family Foundation and the Pew Global Attitudes Project, examines how people around the world perceive and prioritize health in their countries and gauge the efforts of donor nations. People in 47 countries were polled on a series of health questions, giving them an opportunity to share their views on health as a priority for their government and in their own lives. Specifically, the survey looks at what people…

  • Explaining Health Reform: Medicare and the New Independent Payment Advisory Board

    Issue Brief

    This brief describes how the new board created under the 2010 health reform law is expected to limit the growth in Medicare spending over time. Starting in 2014, if projected per capita Medicare spending exceeds targets set in the law, the board must recommend ways to reduce Medicare spending, while maintaining quality and access to care for beneficiaries. The board’s recommendations automatically take effect the next year unless Congress adopts an alternative plan to achieve…

  • Explaining Health Reform: Key Changes in the Medicare Advantage Program

    Issue Brief

    This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring the average payment closer to the costs of traditional fee-for-service Medicare, while rewarding plans with high-quality ratings. The brief also describes new benefit requirements for…

  • Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

    Issue Brief

    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. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending.…

  • Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs

    Perspective

    In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the economic, budget and health reform realities he faces, is talking conspicuously about hard choices that may lie ahead. In a short period of time the…

  • Trends in Medicaid Physician Fees, 2003-2008

    Fact Sheet

    This study, published in a Health Affairs Web exclusive, provides the first national and state-by-state update of Medicaid physician fees since 2003. Medicaid has historically reimbursed physicians under fee-for-service at levels below what Medicare and private health insurers would pay for the same services. The study finds that Medicaid fees grew by more than 15 percent from 2003 to 2008, but fell in real terms because the gains did not keep pace with inflation. Medicaid…