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2013 will be a historic year for Medicaid with the implementation of major provisions to expand coverage and streamline enrollment in the Affordable Care Act (ACA) less than a year away, a surge in activity around care delivery reforms that seek to improve care and potentially reduce costs, and the unfolding of fiscal developments at…
Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs. These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such as long-term care).
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.
Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs.
Managed 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.
A number of states have used the flexibility of the Medicaid program to develop innovative payment and delivery systems designed to coordinate and improve quality of care. This brief, based on site visits from November 2009 through March 2010, highlights care coordination and related efforts in five states: Alabama, Oklahoma, Oregon, Pennsylvania and Washington state.
There 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.
We recently wrote about the different ways in which the Affordable Care Act (ACA) changes pathways to health insurance coverage for people with HIV, and chronicled these specifics, as well as several outstanding questions, in a policy brief.
The fourth in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that states have been able to enter arrangements with plans for their S-CHIP population fairly easily.
National Perspectives on Medicaid Managed Care Report: National Perspectives on Medicaid Managed Care…
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