Comprehensive Medicaid Managed Care Penetration
Comprehensive Medicaid Managed Care Penetration Download Source KCMU/HMA Survey of Medicaid Managed Care, September 2011
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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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Long-Term Services and Supports in the Financial Alignment Demonstrations for Dual Eligible Beneficiaries
Issue BriefThis issue brief compares the treatment of LTSS in the seven approved capitated financial alignment demonstrations for dual eligible beneficiaries.
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Medicaid Delivery System and Payment Reform: A Guide to Key Terms and Concepts
Fact SheetThere is wide state variation in Medicaid health care delivery and payment systems, as states design and combine service delivery models and payment approaches in a multitude of ways. To help those interested in understanding the diversity of Medicaid reform initiatives underway or in development in states across the country, this guide defines key terms.
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Medicaid and Medicare at 50: Trends and Challenges
FeatureMedicaid and Medicare at 50 – Trends and Challenges Download View JAMA infographic
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Payment and Delivery System Reform in Medicare: A Primer on Medical Homes, Accountable Care Organizations, and Bundled Payments
ReportThis primer providers an overview of certain delivery system reform models that are being examined in traditional Medicare, and explains model goals, financial incentives, potential beneficiary implications, and results so far with respect to Medicare spending and care quality. The primer discusses accountable care organizations, medical homes and bundled payments.
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What You Need to Know About Medicaid Managed Care, Amid the New Federal Rules
News ReleaseManaged care is the most common delivery system for Medicaid. Most states (42, including DC) use comprehensive managed care plans to provide care to at least some of their Medicaid enrollees, according to KFF’s updated explainer. Roughly 3 out of 4 Medicaid enrollees receive care through managed care organizations and payments to these organizations account for over half of total Medicaid spending. Five publicly traded firms – Centene, UnitedHealth Group, Anthem (renamed “Elevance” in 2022),…
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Increasingly Privatized Public Health Insurance Programs in the US
PerspectiveIn this JAMA Forum column, KFF’s Larry Levitt examines the growing role of private insurance companies in public programs, including Medicare Advantage and Medicaid managed care, and the tradeoffs that result.
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Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity
Issue BriefResearch demonstrates that improving population health and achieving health equity will require broad approaches that address social, economic, and environmental factors that influence health. This brief provides an overview of the broad factors that influence health and describes efforts to address them, including initiatives within Medicaid.
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Analysis Suggests Health Insurers Remained Profitable Across Markets Amid Pandemic in 2020
News ReleaseA new analysis of health insurers’ financial data suggests that they remained profitable across markets in 2020 due in part to an unprecedented decrease in health spending and utilization in the spring as the COVID-19 pandemic led to massive shutdowns.