View the Latest: Managed Care
Filter
-
-
The Affordable Care Act Drove Record Annual Increases in Enrollment and Total Medicaid Spending Nationally in FY 2015, As Newly Eligible Adults gained Coverage in Expansion States
News ReleaseHigh Federal Match for Adult Expansion Group Contributed to Substantially Slower State Medicaid Spending Growth in Expansion States Compared to Non-Expansion States Survey Also Finds States Relying More on Managed Care, Undertaking Delivery System Reforms The Affordable Care Act’s Medicaid expansion resulted in record increases in Medicaid enrollment and spending nationally in fiscal year 2015, with both rising an average of nearly 14 percent, according to the 15th annual 50-state Medicaid budget survey by the…
-
Medicaid Managed Care Network Adequacy & Access: Current Standards and Proposed Changes
Issue BriefThis brief describes current network adequacy and availability standards for Medicaid managed care plans, presents related findings from KFF’s 22nd annual Medicaid budget survey, and summarizes proposed changes to network adequacy and access rules in the Managed Care NPRM.
-
State Medicaid Coverage of Family Planning Services: Summary of State Survey Findings
ReportThis report presents state-by-state policies on coverage of key areas in reproductive health for low-income women, including contraception, preconception care, screenings for sexually transmitted diseases and coverage within special state Medicaid family planning programs.
-
Medicaid Authorities and Options to Address Social Determinants of Health
Issue BriefSocial determinants of health (SDOH) are the conditions in which people are born, grow, live, work and age. While there are limits, states can use Medicaid – which, by design, serves a primarily low-income population with greater social needs – to address social determinants of health. This brief outlines the range of Medicaid authorities and flexibilities that can be used to add benefits and design programs to address the social determinants of health.
-
CMS’s 2020 Final Medicaid Managed Care Rule: A Summary of Major Changes
Issue BriefOn November 13, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized revisions to the Medicaid managed care regulations which were proposed in November 2018. CMS previously finalized a major revision to these regulations in 2016. The November 2020 final rule is not a wholesale revision of the 2016 regulations but adopts changes in areas including network adequacy, beneficiary protections, quality oversight, and rates and payment.
-
Major Differences in the BBA Medicaid Managed Care Regulation
Other PostA side-by-side comparison of the original and revised Federal rule for new consumer protection and quality assurance requirements for Medicaid managed care. Side-by-Side Comparison
-
The Development of Capitation Rates Under Medicaid Managed Care Programs: A Pilot Study, Vols. 1 & 2
ReportReport: The Development of Capitation Rates under Medicaid Managed Care Programs: A Pilot Study
-
Making Medicaid Managed Care Work: An Action Plan for Persons Living with HIV
Other PostMaking Medicaid Managed Care Work: An Action Plan for Persons Living with HIV This report, by the National Association of People with AIDS (NAPWA) with support from The Kaiser Family Foundation, describes nine key points for people living with HIV to keep in mind when trying to influence the development of a managed care system that will serve them effectively. Senator John Chafee (R-RI), an acknowledged ally of NAPWA, gratefully accepted the report upon its…
-
How Are Safety Net Hospitals Responding to Health Care Financing Changes?
ReportA new background report sums up how multiple trends have led to a situation where safety net hospitals are feeling more financial pressure and are challenged to subsidize the unprofitable care of theuninsured. Background Paper For a more extensive discussion read our larger report from the same study.