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Quick Take: Medicaid MCOs and Medical Loss Ratio (MLR) Requirements

One mechanism for ensuring that health insurance provides value to consumers for the premiums that they pay, or that others pay on their behalf, is to require insurers to meet a minimum “medical loss ratio” or MLR standard. The MLR is the share of premium revenues that an insurer or…

Medicaid and HIV/AIDS Policy: A Basic Primer

The Medicaid Primer presents in depth information on Medicaid, the federal/state program that provides health coverage for low-income families and people with disabilities and is the largest source of public financing for HIV/AIDS care in the U.S. The Medicaid Primer is designed to help policymakers and advocates navigate through the…

Managed Care for Low-Income Populations with Special Needs: The Oregon Experience

This report focuses on Oregon's experience in moving their disabled Medicaid beneficiaries into managed care. It is one of a series of reports from The Kaiser/Commonwealth Low-Income Coverage and Access Project. This project examines how changes in the Medicaid program have affected health insurance coverage and access to care for…

Medicaid Support for Family Planning in the Managed Care Era

As the largest source of public funding for contraceptive care in the United States, Medicaid plays a crucial role in financing family planning services and supplies for millions of low-income women across the nation. In the past 15 years, managed care has become the primary way of delivering care to…

Managed Care and Low-Income Populations: A Case Study of Managed Care in Tennessee

TennCare represents one of the most ambitious state-level efforts to restructure Medicaid and expand insurance coverage to the uninsured. The case study shows that the rapid change caused considerable confusion for patients, providers, and health plans. The TennCare experience provides early insights into the issues that states will face as they move to enroll more of their low-income populations into managed care arrangements.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.