Measuring Long-Term Services and Supports Rebalancing
This fact sheet provides a brief overview of quality measures related to long-term services and supports rebalancing.
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Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations
ReportThis report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.
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Native Americans and Medicaid: Coverage and Financing Issues
Other PostNative Americans and Medicaid:Coverage and Financing Issues Prepared by Andy Schneider and JoAnn Martinez, The Center on Budget and Policy Priorities for The Kaiser Commission on the Future of Medicaid December 1997 Table 1: Medicaid Eligibility Thresholds Pregnant Women, Infants and Children (Effective October 1997) Other Eligibility Categories State Pregnant Women and Infants Children Under…
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Medicaid’s Disabled Population and Managed Care
Other PostMedicaid's Disabled Population and Managed Care This fact sheet highlights the key facts about the Medicaid managed care programs that serve persons with disabilities. It describes the Medicaid disabled population and the role managed care plays in serving them.
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Managed Care and Low-Income Populations: Four Years’ Experience with TennCare
ReportManaged 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.
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Examining Medicaid Managed Long-Term Service and Support Programs: Key Issues To Consider
Issue BriefThere 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.
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Medicaid’s Role for the Disabled Population Under Age 65
Fact SheetMedicaid's Role for the Disabled Population Under Age 65 Defines the non-elderly disabled and summarizes Medicaid's role in their health care coverage. Includes a description of enrollment requirements, benefits, spending and managed care concerns for the population.
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Emerging Medicaid Accountable Care Organizations: The Role of Managed Care
Issue BriefThis brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs.
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Medicaid Delivery System and Payment Reform: A Guide to Key Terms and Concepts
Fact SheetThere is wide state variation in Medicaid health care delivery and payment systems, as states design and combine service delivery models and payment approaches in a multitude of ways. To help those interested in understanding the diversity of Medicaid reform initiatives underway or in development in states across the country, this guide defines key terms.
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Medicaid Managed Care and the Provision of Family Planning Services
ReportThree quarters of reproductive age women on Medicaid are enrolled in managed care arrangements. This analysis explores the experiences and perspectives of leaders of Medicaid Managed Care Organizations (MCOs) in structuring their networks and services to provide family planning and reproductive health services to women. It finds that MCOs rely heavily on safety net clinics including Community Health Centers and Family Planning Clinics such as Planned Parenthood to provide in-network family planning services to their members. MCO leaders also identified churning in enrollment, the high costs of stocking IUDs and implants, global hospital payment methodologies for maternity care, and the inclusion of faith-based providers in plan networks as potential barriers to certain family planning services.