Key Themes in Capitated Medicaid Managed Long-Term Services and Supports Waivers November 14, 2014 Issue Brief This issue brief analyzes key themes in 19 capitated § 1115 and § 1915(b)/(c) Medicaid managed long-term services and supports (MLTSS) waivers approved to date by the Centers for Medicare and Medicaid Services (CMS) with a focus on covered populations and services, provisions aimed at expanding beneficiary access to HCBS, beneficiary protections, and quality measurement and oversight.
How Do Quality and Access Compare In Medicare Advantage Versus Traditional Medicare? November 6, 2014 News Release Today a record three in 10 Medicare beneficiaries are enrolled in Medicare Advantage health plans, mainly HMOs and PPOs, which are paid by the government to provide Medicare benefits to their enrollees. Given the projected rise in Medicare Advantage enrollment, an important question for both consumers and policymakers is how…
What Do We Know About Health Care Access and Quality in Medicare Advantage Versus the Traditional Medicare Program? November 6, 2014 Report As the number of Medicare Advantage enrollees continues to climb, there is growing interest in understanding how the care provided to Medicare beneficiaries in Medicare Advantage plans differs from the care received by beneficiaries in traditional Medicare. This literature review of more than 40 studies synthesizes the evidence to date comparing access and quality for beneficiaries in Medicare Advantage plans and traditional Medicare.
Managing a High Performing Medicaid Program October 7, 2013 Report This report discusses key responsibilities that the federal government and states hold for managing the Medicaid program and identifies the key issues and challenges states face as they transform the way they do business and achieve key national goals. The paper relies on an extensive review of federal and state administrative responsibilities drawn from statute, regulation, and relevant literature, coupled with discussions with six current Medicaid directors.
What is Medicaid’s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence August 2, 2013 Issue Brief Medicaid now covers more than 1 in every 5 Americans, and millions of uninsured individuals will become newly eligible for Medicaid under the ACA. Considering Medicaid’s large and growing coverage role, an evidence-based assessment of the program’s impact on access to care, health outcomes, and quality of care is of major interest. This brief takes a look at what the research literature shows regarding the difference Medicaid makes.
The Future of Medicare Advantage: Are We on the Right Path? June 10, 2013 Event This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act’s reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.
Quality of Care in Community Health Centers and Factors Associated with Performance June 10, 2013 Issue Brief This study examines quality among health centers relative to Medicaid managed care organizations (MCOs). Chronic care quality among health centers is high; gaps in women’s preventive care are a concern. Lower-performing health centers have very high uninsured and homeless rates. The expansion of Medicaid and private insurance under the ACA may foster gains in health center quality performance.
The Right Care at the Right Time: Are Retail Clinics Meeting a Need? June 18, 2012 Event The Alliance for Health Reform and WellPoint, Inc. discuss the role of urgent care centers and retail clinics emerging within the health care system. Panelists will explore such questions as: Can savings and improved access to care be produced through alternative care settings? Will these settings reduce emergency room use…
Performance Measurement Under Health Reform: Proposed Measures For Eligibility and Enrollment Systems and Key Issues and Trade-offs to Consider December 1, 2011 Issue Brief The adoption of new eligibility and enrollment requirements under the Affordable Care Act (ACA) provides states and the federal government an important opportunity to implement a meaningful set of performance measures for eligibility and enrollment systems. Performance measures could be used at the federal level to assess state performance in…