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  • At Least 37 States Have Medicaid State Directed Payments for Hospital Services That Could Be Reduced by the 2025 Reconciliation Law Limits

    Analysis: At Least 37 States Have Medicaid State Directed Payments for Hospital Services That Could Be Reduced by the 2025 Reconciliation Law Limits

    News Release

    An estimated $60 billion in federal Medicaid spending in 37 states (including the District of Columbia) would likely exceed new federal limits on state directed payments for hospital services once fully implemented, a new KFF analysis finds. States with the biggest potential reductions in Medicaid payments to hospitals include California, Illinois, Kentucky, Texas, North Carolina, Louisiana, Arizona and Michigan.

  • 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.

  • What You Need to Know About Medicaid Managed Care, Amid the New Federal Rules 

    News Release

    Managed 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),…