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Medicaid Work RequiremEnts

Key Issues for the Medical Frailty Exemption from Medicaid Work Requirements

CMS has released new guidance on Medicaid work requirements. For background on the medical frailty exemption, one of the key issues in the new rule, check out KFF's explainer. KFF is closely tracking how states are approaching implementation of Medicaid work requirements and navigating related challenges.

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understanding medicaid

Medicaid Financing

Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term care. This brief examines key questions about Medicaid financing and how it works.

Medicaid Program Integrity

This brief explains what is known about improper payments and fraud and abuse in Medicaid and describes ongoing state and federal actions to address program integrity.

Medicaid and Provider Taxes

All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.

Medicaid and Hospitals

Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.

Medicaid Home Care

This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services”) is, who is covered, and what services were available in 2025.

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  • Medicaid Long-Term Services and Supports (LTSS) Users Accounted for Nearly Half of Medicaid Spending, FY 2010

    Feature

    Medicaid Long-Term Services and Supports (LTSS) Users Accounted for Nearly Half of Medicaid Spending, FY 2010 Download Source KCMU and Urban Institute estimates based on data from FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 reports. Because the 2010 data were unavailable, 2009 data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

  • Medicaid Acute and Long-Term Services and Supports Spending Per Enrollee, by Beneficiary Population, FY 2010

    Feature

    Medicaid Acute and Long-Term Services and Supports Spending Per Enrollee, by Beneficiary Population, FY 2010 Download Source KCMU and Urban Institute estimates based on data from FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 reports. Because 2010 data were unavailable, 2009 MSIS data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

  • Long-Term Care Costs Can Exceed Seniors’ Income

    Feature

    Long-Term Care Costs Can Exceed Seniors’ Income Download Source MetLife Mature Market Institute. The 2012 MetLife Market Survey of Nursing Home, Assisted Living, Adult Day Services, and Home Care Costs, November 2012, available at: https://www.metlife.com/mmi/research/2012-market-survey-long-term-care-costs.html#keyfindings; U.S. Census Bureau, Current Population Survey, 2012 Annual Social and Economic Supplement, Table POV01.

  • Distribution of Medicaid Beneficiaries Who Use Long-Term Services and Supports, by Dual Eligibility Status, FY 2010

    Feature

    Distribution of Medicaid Beneficiaries Who Use Long-Term Services and Supports, by Dual Eligibility Status, FY 2010 Download Source KCMU and Urban Institute estimates based on FY 2010 Medicaid Statistical Information System (MSIS) and Centers for Medicare & Medicaid Services (CMS)-64 data. Because 2010 data were unavailable, 2009 MSIS data were used for CO, ID, MO, NC, and WV, and then adjusted to 2010 CMS-64 spending levels.

  • Managing Care Transitions in Medicaid: Spotlight on Community Care of North Carolina

    Issue Brief

    Community Care of North Carolina’s Transitional Care Program (TCP) provides robust transition planning for high-risk Medicaid inpatients to support sound transitions from the hospital back to the community and reduce emergency department use and readmissions. Integral elements of the TCP are hospital-based care managers who coordinate with care managers in medical home practices; centralized health information technology, and standard care management training and tools.

  • Managing a High Performing Medicaid Program

    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.