Medicaid Home Care (HCBS) in 2025
This 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 2025.
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Medicaid Financing: The Basics
Issue BriefMedicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term services and supports for low-income residents. This brief examines key questions about Medicaid financing and how it works.
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Medicaid Managed Care Reporting and Transparency: Managed Care Program Annual Reports
Issue BriefThis brief describes the Managed Care Program Annual Report (MCPAR), a relatively new, comprehensive report on state Medicaid managed care programs that includes plan-level data. It is aimed at improving state and federal managed care program monitoring, oversight, and transparency.
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Health Insurer Financial Performance in 2024
Issue BriefThis analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets.
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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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Medicaid Enrollment in Managed Care by Plan Type
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State Medicaid Officials Project Flat Enrollment Post Unwinding but Increased Spending and Budget Pressures, as States Prepare for Impact of Federal Medicaid Policy Changes
News ReleaseAs states completed the “unwinding” of pandemic-era continuous coverage, Medicaid enrollment fell 7.6% in FY 2025 and is expected to be largely flat in FY 2026. At the same time, total Medicaid spending grew by 8.6% in FY 2025 and is expected to grow by 7.9% in FY 2026.
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States Respond to COVID-19 Challenges but Also Take Advantage of New Opportunities to Address Long-Standing Issues
ReportThis report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings are drawn from the 21st annual budget survey of Medicaid officials in all 50 states and the District of Columbia 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 2021, particularly those related to the…
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Are the Tradeoffs from Prior Authorization Worth It?
From Drew AltmanIn his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs.
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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.