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The Henry J. Kaiser Family Foundation

Early Insights From Ohio’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Ohio is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.

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The Henry J. Kaiser Family Foundation

Briefing on the ACA in CA: Year One & Beyond

Continuing an effort to explore Affordable Care Act (ACA) implementation in the states, the Kaiser Family Foundation and the Blue Shield of California Foundation examined ACA implementation in California (CA) at a Sacramento, Calif. briefing and panel discussion on May 28. A state official, experts and advocates discussed issues and challenges related to implementation of the law, and the practical impact of providing coverage to roughly 4.5 million Californians who have coverage via the state marketplace or the Medi-Cal expansion.

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The Henry J. Kaiser Family Foundation

Access to Care for the Insured and Remaining Uninsured: A Look at California During Year One of ACA Implementation

California is a bellwether state for understanding the impact of the Affordable Care Act (ACA). Much attention has been paid to enrollment in California’s new coverage options, such as the Medicaid expansion (Medi-Cal) and plans sold through ACA marketplaces (Covered California), and to changes in the uninsured from 2013 to 2014. However, less is known about how this coverage has affected people’s access to care and financial security, and why others remain uninsured. This report, based on the 2014 Kaiser Survey of Low-Income Americans aims to fill this gap by comparing the newly insured, previously insured and remaining uninsured across several of these important dimensions.

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The Henry J. Kaiser Family Foundation

Demonstrations to Improve the Coordination of Medicare and Medicaid for Dually Eligible Beneficiaries: What Prior Experience Did Health Plans and States Have with Capitated Arrangements?

This report examines the Center for Medicare and Medicaid Services (CMS) financial alignment demonstration for beneficiaries dually eligible for Medicare and Medicaid, with a focus on the extent to which participating states and health plans have prior experience with capitated managed care arrangements under Medicare or Medicaid, and specifically for this population. Under these capitated financial alignment demonstrations, health plans contract with the state and CMS (a three-way contract) to provide both Medicare and Medicaid benefits to dually eligible beneficiaries. These demonstrations aim to improve the quality of care and the coordination of benefits for people dually eligible for Medicare and Medicaid. The report finds considerable variation in the experience of states and health plans participating in these demonstrations, and discusses the potential implications for beneficiaries and plan oversight.

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The Henry J. Kaiser Family Foundation

Renewals in Medicaid and CHIP: Implementation of Streamlined ACA Policies and the Potential Role of Managed Care Plans

This brief reviews the new renewal requirements for Medicaid and CHIP that are designed to maintain continuity of coverage for eligible individuals. It provides an overview of state implementation of the new renewal policies and considers the potential role managed care plans can play in supporting renewals. Key findings include: some aspects of the simplified renewal policies have not yet been fully implemented due to a range of challenges; some states, including Washington and Rhode Island, have successfully implemented the new policies and achieved high retention rates with more than nine in ten enrollees successfully renewed; and, managed care plans can support renewals by reminding members to renew and providing direct assistance with the renewal process; however, plans identified challenges to supporting renewal.

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The Henry J. Kaiser Family Foundation

Medicare and Medicaid at 50 Years: Perspectives of Beneficiaries, Health Care Professionals and Institutions, and Policy Makers

In this article for the Journal of the American Medical Association (JAMA), Drew Altman and former U.S. Senate Majority Leader William Frist examine the roles the Medicaid and Medicare play in the health system today from the perspectives of the public and beneficiaries, providers, and policymakers, and discusses the challenges they face in the future. The article is accompanied by an audio interview with Altman and Frist, who is a member of the Foundation’s board of trustees.

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The Henry J. Kaiser Family Foundation

Dual Eligible Demonstrations: The Beneficiary Perspective

This issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.

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The Henry J. Kaiser Family Foundation

New Analysis Shows States with Medicaid Expansion Experienced Declines in Uninsured Hospital Discharges

Expanded health insurance coverage through the Affordable Care Act (ACA) is having a major impact on hospital payer mix across the country. Similar to other reports recently released, new data examining hospital discharges in 16 states with data through the second quarter in 2014 show increases in Medicaid and declines in uninsured or self-pay discharges in states that implemented the Medicaid expansion. These trends hold true for all hospital discharges as well as for specific services such as mental health or asthma. This information adds to a growing body of evidence indicating that coverage expansions are affecting providers and may lead to decreases in uncompensated care for the uninsured.

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The Henry J. Kaiser Family Foundation

Poll: Public Views the ACA More Favorably Than Congress’ Plan to Replace It, Though Republicans Favor the Replacement

Public Grows More Pessimistic About How Repeal Will Affect Them Personally Most (55%) of the public holds an unfavorable view of the Congressional plan that would repeal and replace the Affordable Care Act, and the same share (55%) want the Senate either to make major changes to the House-passed bill…

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The Henry J. Kaiser Family Foundation

Data Note: Variation in Per Enrollee Medicaid Spending

This data note looks at Medicaid spending per full-benefit enrollee, examining variation by state and by eligibility group, as well as variation within a given state and eligibility group.

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