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  • Even as HMO enrollment has declined and government regulation of managed care practices has increased, problems with health insurance have not disappeared – they’ve just morphed, explains Larry Levitt, KFF Executive Vice and President for Health Policy

    A Backlash Against Health Insurers, Redux

    Perspective

    In this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns – as well as how consumer protections against coverage restrictions have evolved and fallen short.

  • States Focus on Cost Containment as a Loss of Federal Stimulus Funds Means State Costs for Medicaid Will Jump in FY 2012

    News Release

    NEWS RELEASEThursday, October 27, 2011 New 50-State Survey Finds Cuts In Provider Payments And Changes In Delivery Of Services WASHINGTON, D.C. - Faced with the end of stimulus money and a continuing weak economy, Medicaid officials in virtually every state are enacting a variety of cost cutting measures as states’ spending for Medicaid is projected to increase 28.7 percent this fiscal year to make up for the loss of federal funds, according to a new survey…

  • An Overview of Recent Section 1115 Medicaid Demonstration Waiver Activity

    Issue Brief

    This brief summarizes and examines the implications of recent Section 1115 Medicaid waiver activity. Section 1115 waivers provide states flexibility to test new approaches in Medicaid that differ from federal program rules and can have significant impacts for beneficiaries, providers, and states. While recent waivers and waiver proposals vary in their specific goals and approaches, some key themes are emerging, including using Section 1115 waiver authority to get a jump start on the 2014 Medicaid…

  • Emerging Medicaid Accountable Care Organizations: The Role of Managed Care

    Issue Brief

    This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs. An ACO is a provider-run organization in which participating providers are collectively responsible for the care of an enrolled population, and may share in any savings associated with improvements in the quality and efficiency of care. The structure of Medicaid ACO initiatives is influenced by individual states’ experience with managed care, other existing care delivery…

  • Quick Take: Medicaid: 3 Key Issues to Watch in 2013

    Fact Sheet

    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 the state and federal level. Today, Medicaid provides health and long-term care coverage to more than 60 million low-income children,…

  • Managing a High Performing Medicaid Program

    Report

    This report discusses key responsibilities that the federal government and states hold for managing the Medicaid program and identifies the key issues and challenges states face as they transform the way they do business and achieve key national goals. The paper relies on an extensive review of federal and state administrative responsibilities drawn from statute, regulation, and relevant literature, coupled with discussions with six current Medicaid directors.

  • 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…

  • Proposed Rule on Medicaid Managed Care: A Summary of Major Provisions

    Issue Brief

    This 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.