Medicaid Arrangements to Coordinate Medicare and Medicaid for Dual-Eligible Individuals
This issue brief describes how state Medicaid programs are implementing arrangements aimed at coordinating Medicare and Medicaid for dual-eligible individuals.
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Strategies to Manage Unwinding Uncertainty for Medicaid Managed Care Plans: Medical Loss Ratios, Risk Corridors, and Rate Amendments
Issue BriefThis 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.
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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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A Look at Recent Medicaid Guidance to Address Social Determinants of Health and Health-Related Social Needs
Policy WatchThis policy watch discusses the new opportunities available to states to address health-related social needs through managed care and through Section 1115 demonstration waivers.
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Understanding the Role of Medicaid Managed Care Plans in Unwinding Pandemic-Era Continuous Enrollment: Perspectives from Safety-Net Plans
Issue BriefThis 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.
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How the Pandemic Continues to Shape Medicaid Priorities: Results from an Annual Medicaid Budget Survey for State Fiscal Years 2022 and 2023
ReportThis 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.
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Medicaid Managed Care Plans Can Help Enrollees Maintain Coverage as the Public Health Emergency Unwinds
Issue BriefThroughout 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…
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California Efforts to Address Behavioral Health and SDOH: A Look at Whole Person Care Pilots
Issue BriefAs 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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State Delivery System and Payment Strategies Aimed at Improving Outcomes and Lowering Costs in Medicaid
Issue BriefState Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. This brief examines what delivery system and payment reform initiatives are in place across states; how are states linking financial incentives and using transparency to improve quality and outcomes; and how are states leveraging managed care plan contracts to advance delivery system…
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State Policies Expanding Access to Behavioral Health Care in Medicaid
Issue BriefOn KFF’s 21st annual Medicaid budget survey, all responding states reported at least one initiative to expand behavioral health care in Medicaid, including crisis service and other benefit expansions, initiatives to expand telehealth and address equity, and managed care changes.