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  • Key Issues in State Implementation of the New and Expanded Home and Community-Based Services Options Available Under the Affordable Care Act

    Issue Brief

    This brief summarizes the key issues identified and discussed by participants in Kaiser Family Foundation’s Commission on Medicaid and the Uninsured's July 16, 2013 roundtable meeting on state adoption of the new and expanded Affordable Care Act home and community-based services (HCBS) options. While states have made overall progress in rebalancing their long-term care systems in favor of community-based care, state adoption of ACA HCBS options has been relatively slow to date, despite the growing…

  • Improving the Financial Accountability of Nursing Facilities

    Report

    This report examines nursing facility expenditures to assess relative spending increases in areas such as nursing services, administrative costs, and profits. Using California as a case study, it explores reimbursement by cost category and a standard medical loss ratio (MLR) as potential policy options to improve nursing facility financial accountability and care quality.

  • Medicaid Financial Eligibility: Primary Pathways for the Elderly and People with Disabilities

    Issue Brief

    This issue brief details the various eligibility pathways by which individuals with disabilities and the elderly can qualify for Medicaid coverage. The program, which serves as a safety net for many of the nation’s poorest and sickest individuals, provides health coverage to nearly 60 million Americans, including 8.5 million with disabilities and 8.8 million low-income frail, elderly and disabled Medicare beneficiaries who rely on Medicaid to fill Medicare’s gaps.  Issue Brief (.pdf)

  • Filling In The Long-Term Care Gaps

    Event Date:
    Event

    At a June 3 hearing of the Senate Special Committee on Aging, Diane Rowland, Executive Vice President of the Kaiser Family Foundation and Executive Director on the Kaiser Commission on Medicaid and the Uninsured, testified on the key challenges to providing a larger role for private long-term care insurance in financing long-term care for the elderly and people with disabilities. Her testimony coincided with the release of a policy brief on long-term care financing by…

  • CMS’s Final Rule on Medicaid Managed Care: A Summary of Major Provisions

    Issue Brief

    On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.

  • Trends in State Medicaid Programs: Looking Back and Looking Ahead

    Issue Brief

    For 15 years, KCMU and HMA have conducted annual surveys of Medicaid programs across the country. The NAMD has formally collaborated on this project since 2014. This brief provides a look back at the enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care since as well as highlighting more recent data on managed…

  • Medicaid at 50: A Look Back – And Ahead

    Event Date:
    Event

    Medicaid, the main health insurance program for low-income people and the single largest source of public coverage in the U.S., turns 50 this year. In that time, it has grown to cover nearly 70 million Americans and become a key source of financing for safety net hospitals and health centers, as well as the main source of coverage and financing of long-term care. The program continues to be a focus of policy debate and partisan…

  • Medicaid Balancing Incentive Program: A Survey of Participating States

    Report

    The Balancing Incentive Program provides enhanced federal matching funds, allowing states to advance their efforts to rebalance Medicaid long-term services and supports (LTSS) spending and expand access to home and community-based services as an alternative to institutional care. This report highlights participating states' efforts to implement the program's three structural requirements and use the enhanced federal funds in support of other Medicaid LTSS rebalancing efforts.

  • Health Affairs Blog: Can States Substantially Reduce Medicaid Spending Through Delivery System And Financing Reform?

    Perspective

    In a Health Affairs blog post,  Joshua M. Wiener and Melissa Romaire of RTI International and MaryBeth Musumeci of the Kaiser Family Foundation examine whether states could successfully cope with substantial reductions in federal Medicaid funding under a per capita cap or block grant system by improving efficiency in the way both acute and long-term care are delivered and paid for under the program. A review of the evidence in literature suggests that large Medicaid…