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Medicare Health Plans and Dually Eligible Beneficiaries: Industry Perspectives on the Current and Future Market
ReportAs federal and state governments advance efforts to better coordinate care and reduce costs for people dually eligible for both Medicare and Medicaid benefits, this brief examines how insurers now serving these markets view the opportunities and challenges, including a look at Medicare Advantage Special Needs Plans.
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Managed Care and Low Income Populations in Texas: 1996-1998 Update
ReportThis report, Managed Care and Low-Income Populations in Texas: 1996-1998 Update, updates our 1996 case study of Texas' Medicaid managed care initiatives and their affect on low-income populations. The authors conclude that Medicaid managed care in Texas has had mixed results.
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Medicaid Managed Care: An Analysis of the Health Care Financing Administration’s Notice of Proposed Rulemaking
ReportMedicaid Managed Care: An Analysis of the Health Care Financing Administration's Notice of Proposed Rulemaking Report: Medicaid Managed Care: An Analysis...
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Proposed Rule on Medicaid Managed Care: A Summary of Major Provisions
Issue BriefThis issue brief summarizes major provisions of the Notice of Proposed Rulemaking (NPRM) to modernize and strengthen federal Medicaid managed care regulations, which serves as an informational guide to key proposed new federal expectations and requirements of states and managed care arrangements, and federal oversight interests moving forward.
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New Article and Infographics in JAMA Examine Medicaid and Medicare at 50 Years
News ReleaseThe July 28 special issue of the Journal of the American Medical Association (JAMA) includes an article written by Kaiser Family Foundation President and CEO Drew Altman and former U.S. Senate Majority Leader William H. Frist, MD, and two infographics from the Foundation that examine the past, present, and future of Medicaid and Medicare.
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State Medicaid Eligibility Policies for Individuals Moving Into and Out of Incarceration
Issue BriefThis brief highlights how state eligibility policies for incarcerated individuals differ, based on a review of state statutes, regulations, Medicaid eligibility manuals and other Medicaid agency guidance publicly available online and Medicaid managed care contracts. Overall, state Medicaid eligibility policies for justice-involved individuals moving into and out of incarceration vary, and these policies affect if and when individuals may enroll in Medicaid and the scope of any resulting savings.
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Dual Eligible Demonstrations: The Beneficiary Perspective
Issue BriefThis issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.
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Health Plan Enrollment in the Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries
Fact SheetThis fact sheet shows enrollment in the capitated financial alignment demonstrations for dual eligibles as of July 2017.
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Trends in State Medicaid Programs: Looking Back and Looking Ahead
Issue BriefFor 15 years, KCMU and HMA have conducted annual surveys of Medicaid programs across the country. The NAMD has formally collaborated on this project since 2014. This brief provides a look back at the enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care since as well as highlighting more recent data on managed care and delivery system reforms collected as part of this annual survey. Looking ahead, the survey will continue to capture the evolution of the Medicaid program with a focus program changes during economic cycles as well as innovations in payment and delivery system reform.