Among Dual Eligibles, Identifying The Highest Cost Individuals Could Help In Crafting More Targeted And Effective Responses April 1, 2012 Report This Health Affairs article by researchers at the Urban Institute analyzes linked Medicare and Medicaid data to examine dual eligibles’ utilization and spending in both programs in 2007. It finds that while the population of people dually eligible for Medicare and Medicaid is indeed costly, it is not monolithic. For…
An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees April 1, 2012 Issue Brief Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans…
Using Data and Technology to Drive Process Improvement in Medicaid and CHIP: Lessons From South Carolina March 30, 2012 Fact Sheet In the past year, there has been a notable trend of states increasingly utilizing data and technology to modernize, streamline, and gain efficiencies in their Medicaid and CHIP programs. The expanded use of data and technology is not only helping states deal with current budget pressures and decreased administrative resources,…
The Health Reform Law’s Medicaid Expansion: A Guide to the Supreme Court Arguments March 29, 2012 Issue Brief One significant element of the pending U.S. Supreme Court case challenging the Affordable Care Act is the constitutionality of the law’s Medicaid expansion. This provision of the law requires states that choose to participate in the Medicaid program to cover nearly all adults under age 65 with household incomes at…
A Guide to the Medicaid Appeals Process March 29, 2012 Issue Brief This background brief provides a comprehensive look at the appeals process for the Medicaid program, which differs significantly from those available through the Medicare program and private health insurance. The Medicaid appeals process provides redress for individual applicants and beneficiaries seeking eligibility for the program or coverage of prescribed services,…
KFF Data Note: Americans’ Views on the Personal Impact of the ACA and the Supreme Court’s Decision March 26, 2012 Perspective As the Supreme Court hears cases challenging the constitutionality of parts of the Affordable Care Act, a relatively small share of the public thinks the Supreme Court’s decision will have a lot of impact on their family (28 percent). At the same time, the public is divided as to whether…
Small Area Variations and the ACA’s Coverage Expansions March 6, 2012 Perspective A new Kaiser analysis sheds light on how the country might react to the Affordable Care Act (ACA) when it is implemented. It looks at how the benefits of the ACA’s coverage expansions will vary around the country by census areas (technically, Public Use Microdata Areas, or PUMAs). PUMAs are…
Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors March 3, 2012 Issue Brief As part of broad deficit-reduction plans, policymakers are considering reforms to the nation’s three major entitlement programs – Medicare, Medicaid and Social Security – that could significantly affect the economic security of seniors in their retirement years. This brief examines the role of these programs in ensuring seniors’ financial security…
Governors’ Budgets for FY 2013 — What is Proposed for Medicaid? March 1, 2012 Issue Brief This report provides Medicaid highlights from governors’ proposed state budgets for FY 2013, which starts July 1, 2012 for most states. While some states are beginning to see signs of economic recovery, many remain cautiously optimistic as they continue to experience the recession’s lingering effects. State revenues have not rebounded…
The New Review and Approval Process Rule for Section 1115 Medicaid and CHIP Demonstration Waivers March 1, 2012 Fact Sheet For many years, Section 1115 waivers have been used in the Medicaid program to provide states an avenue to test and implement coverage approaches that do not meet federal program rules, but there have been longstanding concerns about the lack of public input and transparency in the waiver approval process.…