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  • End of Pandemic-Era Policies in Medicaid Home- and Community-Based Services Could Challenge Family Caregivers and Enrollees

    News Release

    Family caregivers played a key role in supporting people who used Medicaid home- and community-based services (HCBS) during the COVID pandemic. Many states used new pandemic-era authorities to support and pay family caregivers and maintain services in other ways amid workforce shortages and other challenges. Now, several states are ending payments to family caregivers and unwinding other pandemic-era policies, which could complicate ongoing workforce shortages and create new challenges for enrollees, according to survey of…

  • A Side-by-Side Comparison of Selected Medicare Prescription Drug Coverage Proposals

    Report

    This document provides a side-by-side comparison of four major federal proposals under consideration to provide outpatient prescription drug coverage to Medicare beneficiaries. It begins with a summary table comparing key features of each proposal, followed by a detailed comparison of the following major proposals: Clinton/Moynihan (The Medicare Modernization Act), House-Passed Plan (The Medicare Rx 2000 Act), Breaux/Frist (The Medicare Prescription Drug and Modernization Act), and Graham/Bryan/Robb (The Medicare Outpatient Drug Act of 2000). Side-by-side

  • The Role of PBMs in Managing Drug Costs: Implications for a Medicare Drug Benefit

    Other Post

    Extending a drug benefit to Medicare beneficiaries has been a highly publicized issue in recent months. To address the question of how to finance and administer such a benefit while controlling its cost, some have proposed using pharmacy benefit managers (PBMs)--companies that administer pharmaceutical benefits for health plans, HMOs, and employers while managing drug utilization and obtaining discounts from both retail pharmacies and manufacturers. Most recently, the Clinton Administration introduced a proposal for a Medicare…

  • The Burden of Out-of-Pocket Health Spending Among Older Versus Younger Adults: Analysis from the Consumer Expenditure Survey, 1998-2003

    Issue Brief

    UPDATED: An updated version of this analysis is now available online. Recent policy debate has focused on the issue of rising health care costs and whether it might be possible to control costs by requiring consumers to pay a larger share of their health care costs out of pocket. While most of the policy discussion has focused on people of working age, rising health care costs and the burden of out-of-pocket spending also affects seniors,…

  • Dementia and Medicare Managed Care: A Growing Challenge for Health Plans

    Report

    The American Bar Association Commission on Legal Problems of the Elderly explored the views of Medicare HMOs on enrolling and delivering services to Medicare beneficiaries with dementia. The Commission conducted detailed interviews with professionals at eight diverse Medicare+Choice organizations. Their report provides background information on health care decision-making law and the Medicare program's laws and regulations, and focuses on survey findings in six key areas: marketing, enrollment, health assessments, health care delivery, advance directives, and…

  • Medicare Beneficiaries and HMOs: A Case Study of the Tampa-St. Petersburg Market

    Report

    This case study of the evolution of Medicare managed care in Tampa-St. Petersburg, Florida, is one of four in a series being prepared by Mathematica Policy Research, Inc., for the Kaiser Family Foundation to examine the growth and impact of Medicare managed care. The Medicare risk (HMO) program has developed at different rates and with different degrees of success across the country. The four unique market areas selected for the project include two with high…

  • Medicaid’s Role for Low-Income Medicare Beneficiaries

    Fact Sheet

    Medicaid's Role for Low-Income Medicare Beneficiaries An overview that identifies low-income Medicare beneficiaries (dual eligibles), how Medicaid can provide care for them, and the challenges to accessing care. Fact Sheet

  • A Study of Media Coverage of Health Policy 1997-2000

    Poll Finding

    The debate over President Clinton's national health care reform plan put health care policy at the forefront of the national agenda in 1993 and 1994. After the end of that debate, it remained to be seen whether or not health policy would hold the media's and the public s interest to the same degree. To help answer that and other questions, a comprehensive study of health policy media coverage from 1997 through 2000 - focusing…

  • Seniors and Prescription Drugs: An 8-State Survey

    Report

    A new study conducted by researchers at Tufts-New England Medical Center, the Henry J. Kaiser Family Foundation, and the Commonwealth Fund, reports results from a 2001 survey of 10,927 noninstitutionalized seniors in eight geographically diverse states: California, Colorado, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas. State-level data on drug coverage, medication use, out-of-pocket costs, and cost-related medication skipping among community-dwelling seniors are highlighted to examine how coverage and experiences differ by state and how…