Managed Care and Low-Income Populations: A Case Study of Managed Care in California April 29, 2000 Report This report updates a 1994 case study of California’s Medicaid managed care initiative. California uses three predominant managed care models in its Medi-Cal program: county organized health (COHS), geographic managed care (GMC), and the two-plan model. This case study focuses specifically on Los Angeles County’s two-plan model and Orange County’s…
People with Disabilities and Medicaid Managed Care: Key Issues to Consider February 1, 2012 Issue Brief As many states expand their use of managed care in Medicaid, a growing number of beneficiaries with disabilities are being enrolled in risk-based managed care arrangements for at least some of their care. Further growth in managed care is expected in 2014, when the Affordable Care Act expands Medicaid eligibility…
Examining Medicaid Managed Long-Term Service and Support Programs: Key Issues To Consider October 1, 2011 Issue Brief There is increased interest among states in operating Medicaid managed long-term services and support (MLTSS) programs rather than paying for long-term services and supports (LTSS) on a fee-for-service basis, as has been the general practice. This issue brief examines key issues for states to consider if they are contemplating a…
Innovative Medicaid Initiatives to Improve Service Delivery and Quality of Care: A Look at Five State Initiatives September 1, 2011 Report A number of states have used the flexibility of the Medicaid program to develop innovative payment and delivery systems designed to coordinate and improve quality of care. This brief, based on site visits from November 2009 through March 2010, highlights care coordination and related efforts in five states: Alabama, Oklahoma,…
Medicaid and Managed Care: Key Data, Trends, and Issues February 1, 2012 Issue Brief This brief provides a snapshot of the Medicaid program’s use of managed care to deliver services to beneficiaries. It examines the prevalence of managed care in state Medicaid programs; the various approaches states have used, including primary-care case management; managed care for long-term services and for beneficiaries dually eligible for…
The Changing Medicaid Managed Care Market April 29, 1999 Report Trends in Commercial Plans' ParticipationThis background paper analyzes the trends in commercial plan participation in the Medicaid market by using a database specifically designed for this purpose. It examines changes from mid-1996 to mid-1997 in the types of full-risk plans serving Medicaid Beneficiaries. It also looks at trends through mid-1998…
Managed Care and Low-Income Populations: Four Years’ Experience with TennCare September 1, 1999 Report Managed Care and Low-Income Populations: Four Years’ Experience with TennCare This report updates an earlier study of Tennessee’s experience with restructuring their Medicaid programs. 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…
Native Americans and Medicaid: Coverage and Financing Issues – Report December 30, 1997 Report Native Americans and Medicaid:Coverage and Financing IssuesPrepared by Andy Schneider and JoAnn Martinez, The Center on Budget and Policy Priorities for The Kaiser Commission on the Future of MedicaidDecember 1997Table Of ContentsHighlights ii I: Background On Native American Health Care 1 II: Medicaid's Role For Native Americans 4 1. Medicaid…
Quick Take: Medicaid MCOs and Medical Loss Ratio (MLR) Requirements April 13, 2012 Fact Sheet 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…
The Crunch Continues: Medicaid Spending, Coverage and Policy in the Midst of a Recession September 2, 2009 Event This annual 50-state survey finds that number of people on Medicaid and state spending on the program are climbing sharply as a result of the recession, straining state budgets and pressuring officials to curb costs despite increased financial help from the federal government through the American Recovery and Reinvestment Act…