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This brief presents findings from a survey and roundtable discussion of Medicaid managed care plans about the role they may play in the unwinding of the pandemic-era continuous enrollment provision.
A 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. How many states are planning Medicaid managed care expansions? What impact would these changes have on beneficiaries, providers and health plans? What have we learned from past efforts to expand managed care? This briefing, cosponsored by the Alliance…
This 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. Both waivers affect hundreds of thousands of Medicaid beneficiaries, involve billions of federal Medicaid matching funds, and are designed, in part, to promote changes in the health care delivery system that will…
Most Medicaid beneficiaries nationally are enrolled in some form of managed care, and, with current budget pressure and health reform on the horizon, states are expected to increase their reliance on managed care to deliver services in their Medicaid programs. This 50-state survey, conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, provides a comprehensive look at state Medicaid managed care programs, documenting their diversity, examining how states monitor access…
States are increasingly interested in the individual budget model for older Medicaid beneficiaries as a mechanism to improve responsiveness of benefits to beneficiaries’ needs and preferences and to increase their ability to remain outside or leave nursing homes. Beginning in January 2007, a new provision in the Deficit Reduction Act of 2005 (DRA) allows states to offer an individual budget option for an expanded range of home- and community-based services in their Medicaid state plans…
This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and the demonstrations in each state are set to begin in April 2013. Fact Sheet (.pdf)
Today, one out of every four disabled Medicaid beneficiaries receives health care through managed care. This Background Paper provides insights into how Medicaid managed care is working for individuals with disabilities, based on the findings from seven focus groups held in Florida and New Mexico. The key findings show that adults and children with disabilities feel alone in managing their health care and that important components of managed care - coordination and gatekeeping role that…
Medicaid Managed Care's Impact On Safety-Net Clinics In California Medicaid Managed Care's Impact On Safety-Net Clinics In California was published in the January/February 2000 issue of the journal Health Affairs. The report provides an overview of Medi-Cal Managed Care in California, and its effects on community health clinics, and related issues. In order to better understand the impact that the Medi-Cal managed care program has had on California safety-net providers, the Kaiser Family Foundation supported…
This report, Medicaid Managed Care for Persons with Disabilities Case Studies of Programs in Florida, Kentucky, Michigan and New Mexico, provides in-depth descriptions of the case studies in these states.
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.…
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