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Medicaid Managed Care: An Analysis of the Health Care Financing Administration's Notice of Proposed Rulemaking Report: Medicaid Managed Care: An Analysis...
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 hte low-income population in eight states: California, Florida, Maryland, Minnesota, New York, Oregon, Tennessee and Texas. Report
The 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. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design contracts to 15 states to develop service delivery and payment models to integrate care for dual eligibles. CMS and the participating states have recognized that…
This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending.…
This report is based on a focus group discussion in May 2012 with the Executive Board of the National Association of Medicaid Directors (NAMD) and other leading Medicaid directors. The group of nine directors reflected perspectives from various regions of the country. The discussion focused on state fiscal conditions, Medicaid spending and enrollment trends, key Medicaid policy changes and federal health care reform implementation. At the time of the meeting, most states were wrapping up…
The Kaiser Family Foundation maintains a number of primers providing overviews of key health care programs and issues. Written by Foundation staff, each primer provides key data and information that helps illustrate the topic and its relevance for the nation's health care system. Medicaid: A Primer Medicare: A Primer The Uninsured: A Primer Health Care Costs: A Primer How Private Health Coverage Works: A Primer Mental Health Financing in the United States: A Primer The…
This commentary reviews Medicaid's role for low-income women and examines the implications Medicaid managed care on the delivery of health services to this vulnerable population. Today 40% of the Medicaid population, mostly poor women and their children, is enrolled in managed care. Medicaid agencies are hoping managed care will control spending and address longstanding problems with access to care. Low-income women have a number of characteristics that make them doubly vulnerable to have trouble accessing…
This report analyzes Maryland's Medicaid managed care program, HealthChoice, an ambitious and broad-reaching effort to reform the financing and delivery of health care for over 300,000 low-income individuals. Implemented in 1997, HealthChoice contains certain innovative features not found in many other state reform efforts, such as protections for traditional providers and development of a new risk adjustment system. This report is one of a series of reports from The Kaiser/Commonwealth Low-Income Coverage and Access Project.…
Medicaid and Managed Care June 1995 This year, Medicaid will finance health and long-term care services to more than 35 million low-income Americans. In its role as a purchaser of health services for low-income families, Medicaid increasingly relies on managed care to deliver care. Almost 8 million Medicaid beneficiaries, predominately poor children and their parents, now receive health care services through a broad array of managed care arrangements, including Health Maintenance Organizations (HMOs) and less…
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