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  • Examining Medicaid Managed Long-Term Service and Support Programs: Key Issues To Consider

    Issue Brief

    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. This issue brief examines key issues for states to consider if they are contemplating a shift to covering new populations and LTSS benefits through capitated payments to traditional risk-based managed care organizations (MCOs). It draws on current literature as well…

  • People with Disabilities and Medicaid Managed Care: Key Issues to Consider

    Issue Brief

    As many states expand their use of managed care in Medicaid, a growing number of beneficiaries with disabilities are being enrolled in risk-based managed care arrangements for at least some of their care. Further growth in managed care is expected in 2014, when the Affordable Care Act expands Medicaid eligibility to many uninsured low-income adults, including those with disabilities. This issue brief looks at issues related to the development and implementation of managed care programs…

  • Managed Care and Low-Income Populations: A Case Study of Managed Care in California

    Report

    This report updates a 1994 case study of California's Medicaid managed care initiative. California uses three predominant managed care models in its Medi-Cal program: county organized health (COHS), geographic managed care (GMC), and the two-plan model. This case study focuses specifically on Los Angeles County's two-plan model and Orange County's COHS model. It is one of a series of reports from the Kaiser/Commonwealth Low-Income Coverage and Access Project. This project examines how changes in the…

  • Medicaid’s Role for the Disabled Population Under Age 65

    Fact Sheet

    Medicaid's Role for the Disabled Population Under Age 65 Defines the non-elderly disabled and summarizes Medicaid's role in their health care coverage. Includes a description of enrollment requirements, benefits, spending and managed care concerns for the population. Fact Sheet

  • Native Americans and Medicaid: Coverage and Financing Issues

    Other Post

    Native Americans and Medicaid:Coverage and Financing Issues Medicaid and Welfare Until 1996, families with children who received cash assistance under the Aid to Families with Dependent Children (AFDC) program were automatically entitled to Medicaid coverage. The welfare law enacted that year, Public Law 104-193, repealed the AFDC program and created a Temporary Assistance for Needy Families (TANF) block grant to the states. The 1996 welfare law also severed the automatic eligibility linkage between welfare and…

  • Growth in Medicaid MCO Enrollment during the COVID-19 Pandemic

    Issue Brief

    This data note looks at state Medicaid managed care enrollment data through March 2021 to assess the impact of the COVID-19 pandemic and economic crisis on Medicaid enrollment. Data collected for 29 states show that the rate of Medicaid managed care enrollment growth was 18.8% when comparing managed care enrollment from March 2020 through March 2021. The rate accelerated compared to March 2020 through September 2020 and reversed the trend seen from March 2019 to…

  • Medicaid Managed Care Rates and Flexibilities: State Options to Respond to COVID-19 Pandemic

    Issue Brief

    This brief provides an overview of how Medicaid managed care organization (MCO) capitation rates are developed by states and approved by CMS, highlights options available to states to adjust current rates and/or risk sharing mechanisms, describes how MCOs pay providers, and outlines state options to direct MCO payments to providers in response to conditions created by the COVID-19 pandemic.

  • One Year into Duals Demo Enrollment: Early Expectations Meet Reality

    Perspective

    One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.

  • 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…