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Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs. These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such as long-term care).
Native Americans and Medicaid:Coverage and Financing Issues Prepared by Andy Schneider and JoAnn Martinez, The Center on Budget and Policy Priorities for The Kaiser Commission on the Future of Medicaid December 1997 Table Of ContentsHighlights ii I: Background On Native American Health Care 1 II: Medicaid's Role For Native Americans 4 1.
This brief summarizes and examines the implications of recent Section 1115 Medicaid waiver activity. Section 1115 waivers provide states flexibility to test new approaches in Medicaid that differ from federal program rules and can have significant impacts for beneficiaries, providers, and states.
This primer providers an overview of certain delivery system reform models that are being examined in traditional Medicare, and explains model goals, financial incentives, potential beneficiary implications, and results so far with respect to Medicare spending and care quality. The primer discusses accountable care organizations, medical homes and bundled payments.
In this JAMA Forum column, KFF’s Larry Levitt examines the growing role of private insurance companies in public programs, including Medicare Advantage and Medicaid managed care, and the tradeoffs that result.
This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. Report findings are drawn from the annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Family Foundation (KFF) and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report examines the reforms, policy changes, and initiatives that occurred in FY 2017 and those adopted for implementation for FY 2018 (which began for most states on July 1, 2017). Key areas covered include changes in eligibility and enrollment, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits (including prescription drug policies), and opioid harm reduction strategies.
Research demonstrates that improving population health and achieving health equity will require broad approaches that address social, economic, and environmental factors that influence health. This brief provides an overview of the broad factors that influence health and describes efforts to address them, including initiatives within Medicaid.
More than half of the nation’s 67.9 million Medicaid beneficiaries now receive their health care in comprehensive managed care organizations (MCOs) – and the number and share are growing.
As the Trump Administration and Congress weigh major changes to Medicaid and programs that fund reproductive health care, new analyses from the Kaiser Family Foundation highlight the current state of coverage and challenges for family planning, pregnancy, and perinatal services in the Medicaid program that provides coverage for millions of low-income women across the nation.
Managed care organizations (MCOs) cover nearly two-thirds of all Medicaid beneficiaries nationwide, making managed care the nation’s dominant delivery system for Medicaid enrollees. As the entities responsible for providing comprehensive Medicaid benefits to enrollees by contracting with providers, managed care plans play a critical role in shaping access to care for Medicaid enrollees. Many plan actions are dictated by state policy or contracting requirements; however, plans also have some flexibility to design payment and delivery systems and structure enrollees’ experiences using their coverage. To understand how Medicaid managed care plans approach access to care and the challenges they face in ensuring such access, the Kaiser Family Foundation conducted a survey of plans in 2017.
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