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  • A Profile of Medicaid Managed Care Programs in 2010: Findings from a 50-State Survey

    Report

    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…

  • Visualizing Health Policy: Medicaid and Medicare at 50: Trends and Challenges

    Other Post

    These Visualizing Health Policy infographics commemorate the 50th anniversary of the Medicaid and Medicare programs. This infographic provides details about the reach and demographics of the programs, as well as the Federal and total US health-care spending associated with them. This infographic illustrates trends and challenges going forward. Together, Medicaid and Medicare provide health insurance coverage for more than 3 in 10 Americans. Medicaid serves a notable share of children, nursing home residents, and Americans younger than 65…

  • Tapping Nurse Practitioners to Meet Rising Demand for Primary Care

    Issue Brief

    More than 58 million Americans, or nearly 1 in 5, live in primary care shortage areas, where the supply of primary care physicians is not sufficient to meet the needs of the population. Particularly as the demand for primary care increases due to population growth, aging, and expanded insurance coverage, strategies to mitigate already sharp strains on primary care capacity are needed. This brief focuses on the opportunity to more fully tap the potential of…

  • Awaiting New Medicaid Managed Care Rules: Key Issues to Watch

    Issue Brief

    More than half of all Medicaid beneficiaries now receive their services in risk-based managed care plans, and states’ use of managed care is expanding. States operate their own Medicaid managed care programs within federal rules and requirements. The federal regulations were last updated in 2002 and a new proposed rule is expected in Spring 2015. This brief identifies key issues in the regulation and discusses how CMS might address them.

  • Medi-Cal Managed Care: An Overview and Key Issues

    Issue Brief

    California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation, insuring almost one-third of Californians. For several decades, Medi-Cal has been transitioning from a fee-for-service (FFS) system to risk-based managed care, and more than three-quarters of all Medi-Cal beneficiaries, including low-income children, adults, seniors, and people with disabilities, are now enrolled in managed care plans. As other state Medicaid programs increase their reliance on risk-based managed care, a review of California’s transition…

  • Trends in Health Plans Serving Medicaid — 2000 Data Update

    Report

    An updated study follows trends in commercial health plan participation in Medicaid managed care and includes new analyses on the performance of Medicaid-dominated and commercial plans on measures of effective care and access to care, and on the extent to which plans restrict their Medicaid service areas.