Emerging Medicaid Accountable Care Organizations: The Role of Managed Care
This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs.
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Quick Take: Medicaid MCOs and Medical Loss Ratio (MLR) Requirements
Fact SheetOne 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.
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An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees
Issue BriefBeginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid.
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A Guide to the Medicaid Appeals Process
Issue BriefThis background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance.
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People with Disabilities and Medicaid Managed Care: Key Issues to Consider
Issue BriefAs 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.
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Medicaid and Managed Care: Key Data, Trends, and Issues
Issue BriefThis brief provides a snapshot of the Medicaid program's use of managed care to deliver services to beneficiaries.
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California and Texas: Section 1115 Medicaid Demonstration Waivers Compared
Fact SheetThis fact sheet compares and contrasts key provisions of the California and Texas Section 1115 Medicaid demonstration waivers. The Texas waiver, approved in December 2011, is modeled, in part, on the California waiver, which has been underway in that state since November 2010.
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Financial Alignment Models for Dual Eligibles: An Update
Issue BriefThe nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs.
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Medicaid Innovations: Can Managed Care Cut Costs and Improve Value?
Event Date:EventA number of states have expressed interest in expanding managed care approaches within their Medicaid programs. While managed care may present an opportunity for better delivery of care, it presents challenges within certain populations and geographic areas.
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States Focus on Cost Containment as a Loss of Federal Stimulus Funds Means State Costs for Medicaid Will Jump in FY 2012
News ReleaseNEWS RELEASEThursday, October 27, 2011 New 50-State Survey Finds Cuts In Provider Payments And Changes In Delivery Of Services WASHINGTON, D.C.