View the Latest: Managed Care
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Prior Authorization Process Policies in Medicaid Managed Care: Findings from a Survey of State Medicaid Programs
Issue BriefThis brief examines state policies related to prior authorization processes in Medicaid managed care and includes findings about how states approach prior authorization decision timeframes, electronic denial notices, and access to external medical reviews, all as of July 1, 2024.
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A Backlash Against Health Insurers, Redux
PerspectiveIn 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.
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What is Medicaid Home Care (HCBS)?
Issue BriefThis issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services” or HCBS) is, who is covered, and what services were available in 2024.
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A Look at Medicaid Enrollment and Finances of the Five Largest Medicaid Managed Care Plans
Issue BriefThis brief examines enrollment and financial data through the end of September 2024 from quarterly company earnings reports and calls, financial filings, and other company materials as well as from national administrative data.
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The Semi-Sad State of Consumer Protection In Health Care
From Drew AltmanIn this column, KFF President and CEO Drew Altman explores the state of consumer protections in health care and explains why, even with consumer frustration clear, Congress is unlikely to pursue major new health insurance protections but there could be some modest steps.
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The Landscape of Medicare and Medicaid Coverage Arrangements for Dual-Eligible Individuals Across States
Issue BriefThis issue brief merged beneficiary-level Medicare and Medicaid data from 2021 to document sources of coverage for dual-eligible individuals nationwide and by state.
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As Pandemic-Era Policies End, Medicaid Programs Focus on Enrollee Access and Reducing Health Disparities Amid Future Uncertainties
ReportThis report highlights certain policies in place in state Medicaid programs in FY 2024 and policy changes implemented or planned for FY 2025, which began on July 1, 2024 for most states.
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North Carolina’s Effort to Relieve Medical Debt
Policy WatchThis policy watch examines the burden of medical debt in North Carolina and the state’s new plan to leverage the Medicaid program to provide debt relief and support access to care for low- and middle-income North Carolinians.
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What the Outcome of the Election Could Mean for Medicaid
Issue BriefThis brief examines the two presidential candidates’ records and other recent policy proposals that could inform starkly different directions for the program across key areas, including Affordable Care Act (ACA) Medicaid expansion, financing, eligibility, benefits, and cost-sharing, prescription drugs, long-term services and supports, and managed care.