Medicaid Arrangements to Coordinate Medicare and Medicaid for Dual-Eligible Individuals
This issue brief describes how state Medicaid programs are implementing arrangements aimed at coordinating Medicare and Medicaid for dual-eligible individuals.
View the Latest: Managed Care
Filter
-
-
North Carolina’s Effort to Relieve Medical Debt
Policy WatchThis policy watch examines the burden of medical debt in North Carolina and the state’s new plan to leverage the Medicaid program to provide debt relief and support access to care for low- and middle-income North Carolinians.
-
What is Medicaid Home Care (HCBS)?
Issue BriefThis issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024.
-
Prior Authorization Process Policies in Medicaid Managed Care: Findings from a Survey of State Medicaid Programs
Issue BriefThis brief examines state policies related to prior authorization processes in Medicaid managed care and includes findings about how states approach prior authorization decision timeframes, electronic denial notices, and access to external medical reviews, all as of July 1, 2024.
-
10 Things to Know About Medicaid Managed Care
Issue BriefOur updated explainer provides an overview of comprehensive managed care, the most common way states deliver Medicaid services to enrollees.
-
-
Medi-Cal Managed Care: An Overview and Key Issues
Issue BriefCalifornia’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation, insuring almost one-third of Californians. For several decades, Medi-Cal has been transitioning from a fee-for-service (FFS) system to risk-based managed care, and more than three-quarters of all Medi-Cal beneficiaries, including low-income children, adults, seniors, and people with disabilities, are now enrolled in managed care plans. As other state Medicaid programs increase their reliance on risk-based managed care, a review of California’s transition is both timely and illustrative. This issue brief provides an overview of the evolution of Medi-Cal managed care, key issues, and lessons for managed care programs in other states.
-
Dual Eligible Demonstrations: The Beneficiary Perspective
Issue BriefThis issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.
-
Adult Behavioral Health Benefits in Medicaid and the Marketplace
ReportThis report analyzes specific specialty behavioral health services covered by state Medicaid programs and Marketplace QHPs in four states: Arizona, Colorado, Connecticut, and Michigan.
-
Early Insights from One Care: Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
Issue BriefMassachusetts is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.