Medicaid Long-Term Services and Supports: Key Changes in the Health Reform Law June 4, 2010 Issue Brief This issue brief examines new opportunities under the health reform law for states to balance their Medicaid long-term care delivery systems by expanding access to Medicaid home and community-based services (HCBS) programs. The brief outlines key provisions of the new law that expand HCBS benefit options, broaden financial and functional…
Medicaid Matters: Understanding Medicaid’s Role in Our Health Care System March 1, 2011 Fact Sheet This fact sheet provides key information about the Medicaid program and its role in our health care system and state economies. The nation’s public health insurance program for low-income people is counter-cyclical, expanding during the recent recession to assist millions of individuals and families affected by the loss of jobs…
Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries October 1, 2012 Issue Brief 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. Starting in 2013, CMS will…
Chronic Disease and Co-Morbidity Among Dual Eligibles: Implications for Patterns of Medicaid and Medicare Service Use and Spending July 1, 2010 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…
A Challenge for States: Assuring Timely Access to Optimal Long-Term Services and Supports in the Community January 30, 2011 Issue Brief The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. The federal government has played an active role in sponsoring initiatives to promote a shift to community-based care; and evidence from…
Financial Alignment Models for Dual Eligibles: An Update November 1, 2011 Issue Brief The nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design…
Articles Examine Data and Issues For Expanding Integrated Care Models For Dual-Eligible Beneficiaries June 1, 2012 Report As state and federal policymakers move to develop and test integrated care models for people dually eligible for Medicare and Medicaid, two new Kaiser Family Foundation articles in the June 2012 issue of Health Affairs highlight the diverse needs and challenges facing these 9 million beneficiaries, describe their current care…
Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries September 30, 2012 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…
State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS September 30, 2012 Report 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…
Health Reform Opportunities: Improving Policy for Dual Eligibles July 30, 2009 Issue Brief As the nation considers national health reform, this brief provides an overview of opportunities to realign federal and state policy for the dual eligibles to promote a more rational, cost-efficient system for 9 million of the poorest, sickest and highest-cost people covered by both Medicaid and Medicare. Navigating two programs…
