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This brief provides a high-level snapshot of states with minimum medical loss ratio (MLR) and remittance requirements and risk corridors in place as of July 1, 2022 that may provide financial protection and limits on financial risk for states and plans as the unwinding unfolds.
In 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.
Delivery system and payment reform are dynamic and ever-evolving policy areas of state Medicaid programs; virtually every state has initiatives underway. This interactive is designed to provide users with an environmental scan of the activity.
This policy watch discusses the new opportunities available to states to address health-related social needs through managed care and through Section 1115 demonstration waivers.
This brief presents findings from a survey and roundtable discussion of Medicaid managed care plans about the role they may play in the unwinding of the pandemic-era continuous enrollment provision.
This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 22nd annual budget survey of Medicaid officials conducted by KFF and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors (NAMD). This report highlights policies in place in state Medicaid programs in FY 2022 as well as policy changes implemented or planned for FY 2022.
Throughout the pandemic, states have worked with managed care plans to respond to changing public health conditions and new developments. After the PHE ends, state Medicaid agencies will need to complete a large number of eligibility and enrollment tasks and actions, including processing renewals, redeterminations (based on changes in circumstance), and post-enrollment verifications. Medicaid managed care plans can assist state Medicaid agencies in communicating with enrollees, conducting outreach and assistance, and ultimately, in improving coverage retention (including facilitating transitions to the Marketplace where appropriate).
As California ramps up its CalAIM initiative, the state will incorporate and transition its Whole Person Care pilot program's services statewide through the state’s Medicaid managed care system. This brief examines the lessons from those pilots in coordinating and integrating physical health, behavioral health, and social services.
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