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5 Facts: Medicaid Fraud, Waste, Abuse and Improper Payments

Program integrity efforts work to prevent and detect fraud, waste, and abuse; increase program transparency and accountability; and recover improper payments. This brief explains what we know about these issues and efforts to address program integrity.

Medicaid: What to Watch in 2026

Medicaid: What to Watch in 2026

In this brief, KFF explores how state fiscal pressures are likely to converge with the implementation of the 2025 reconciliation law to affect Medicaid coverage, financing, and access to care over the next year, especially leading up to the midterm elections.

Medicaid Watch

Featuring policy research, polling and news about how Medicaid is changing, and the impact of those changes due to the tax and spending cuts law

Medicaid and work

Tracking Medicaid Work Requirements:
Data and Policies

To implement Medicaid work requirements, states will need to make important policy and operational decisions, implement needed system upgrades or changes, develop new outreach and education strategies, and hire and train staff, all within a relatively short timeframe. The information tracked here can serve as a resource to understand Medicaid work requirements and state options, gauge readiness, and track implementation of the requirements.

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 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.

5 Facts: 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 in 2025

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.

5 Facts: 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.

2025 Medicaid Home Care survey

Payment Rates Ahead of 2025 Reconciliation Law

This issue brief describes Medicaid payment rates for home care and other workforce supports that are in place in 2025, before the majority of the 2025 reconciliation law provisions start taking effect.

Home Care Support for Family Caregivers in 2025
number of responding states, including DC, that allow payments for family caregivers by type of home care program and type of caregiver.

This issue brief describes the availability of self-directed services and supports for family caregivers in Medicaid home care in 2025, before most provisions in the reconciliation law take effect.

States’ Management of Home Care Spending

This issue brief describes the mechanisms states are currently using to limit Medicaid spending on home care and their plans for adopting new mechanisms in state fiscal year (FY) 2026.

Waiting Lists for Medicaid Home Care, 2016 to 2025
A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025

This data note provides new information about waiting lists in Medicaid home care before many of the provisions in the 2025 reconciliation law go into effect.

Eligibility and coverage

  • Eligibility, Enrollment, and Renewal Policies

    KFF's survey findings capture state actions that seek to improve the accuracy and efficiency of Medicaid and CHIP enrollment and renewal processes, as of January 2025.

  • Seniors and People with Disabilities

    More than 1 in 3 people with disabilities (15 million) have Medicaid (35%). In comparison, only 19% of people without disabilities have Medicaid.

  • Children with Special Needs

    Amid debates about proposed cuts to federal Medicaid spending, this brief analyzes key characteristics of children with special health care needs and explores how Medicaid provides them with coverage.

  • People With Intellectual and Developmental Disabilities

    Among the estimated 8 million people with intellectual and developmental disabilities (I/DD), over three million have Medicaid coverage.

  • Adults with Chronic Conditions

    Among working age adults enrolled in Medicaid, approximately three quarters have one or more chronic conditions, and nearly one-third have three or more.

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  • Data Note: A Large Majority of Physicians Participate in Medicaid

    Issue Brief

    About 70% of all office-based physicians accept new Medicaid patients, including two-thirds of primary care physicians and close to three-quarters (72%) of specialists. The percentage of physicians accepting new Medicaid patients varies widely by state, ranging from 39% to 97%. In one-quarter of states, more than 85% of physicians accept new Medicaid patients, including 10 states where at least 90% do. There is no evidence that physician participation in Medicaid is declining.

  • What’s Really At Stake In the Medicaid Spending Debate

    From Drew Altman

    In this Axios column, Drew Altman highlights that the federal debate about the American Health Care Act’s Medicaid spending reductions will ultimately be a debate about every state’s general budget spending priorities, as states discuss whether to offset reductions in federal revenues with some combination of cuts to their Medicaid programs, increased taxes, and cuts to spending in other areas.

  • 5 Ways the Graham-Cassidy Proposal Puts Medicaid Coverage At Risk

    Fact Sheet

    The Graham-Cassidy proposal to repeal and replace the Affordable Care Act (ACA) is reviving the federal health reform debate and could come up for a vote in the Senate before the budget reconciliation authority expires on September 30. This fact sheet describes five ways in which the proposal revamps and cuts Medicaid, redistributes federal funds across states and eliminates coverage for millions of poor Americans.

  • States are Shifting How They Cover Prescription Drugs in Response to COVID-19

    Policy Watch

    Medicaid beneficiaries, particularly those with chronic conditions, will need access to medications even during social distancing and their ability to meet with providers to obtain refills may be hindered. States are updating policies to allow beneficiaries to access medications during this public health emergency.

  • Supporting Work without the Requirement: State and Managed Care Initiatives

    Issue Brief

    The Centers for Medicare and Medicaid Services (CMS) continues to promote state adoption of work and reporting requirements as a condition of Medicaid eligibility for certain nonelderly adults, although several such waivers have been set aside by federal courts. While most Medicaid adults are already working, some states and health plans have developed voluntary work support programs for nonelderly adults who qualify for Medicaid through non-disability pathways. These programs offer services that support work without conditioning Medicaid eligibility on having a job. This brief examines opportunities for and limitations on federal and state support of such programs, highlights several state and health plan initiatives, and explores their common themes.

  • How Do Medicaid/CHIP Children with Special Health Care Needs Differ from Those with Private Insurance?

    Issue Brief

    This issue brief compares the demographics, health status, access to care, and coverage affordability of Medicaid/CHIP children with special health care needs to those with private insurance and those who are uninsured. Medicaid plays a key role for children with special health care needs by making coverage affordable and covering services that private coverage typically does not. Consequently, legislative proposals that would cap and reduce federal Medicaid funding may pose a particular risk to children with special health care needs and their providers. A companion brief describes Medicaid’s role for children with special health care needs.

  • Implications of Emerging Waivers on Streamlined Medicaid Enrollment and Renewal Processes

    Fact Sheet

    The Affordable Care Act (ACA) significantly modernized and streamlined Medicaid enrollment and renewal processes across all states. Through major investments of time, money, and staff, most states have implemented modernized systems that transformed lengthy, paperwork driven enrollment and renewal procedures to a simplified, technology-driven experience that minimizes burdens on individuals and states. Recently approved and proposed waivers and other proposed policies include new eligibility and enrollment requirements and restrictions that run counter to the ACA’s streamlined processes (Figure 1). This fact sheet provides an overview of how enrollment and renewal processes changed under the ACA and the implications of emerging waivers and other proposed changes on streamlined enrollment and renewal.

  • Medicaid Managed Care Plans and Access to Care: Results from the Kaiser Family Foundation 2017 Survey of Medicaid Managed Care Plans

    Report

    Managed care organizations (MCOs) cover nearly two-thirds of all Medicaid beneficiaries nationwide, making managed care the nation’s dominant delivery system for Medicaid enrollees. As the entities responsible for providing comprehensive Medicaid benefits to enrollees by contracting with providers, managed care plans play a critical role in shaping access to care for Medicaid enrollees. Many plan actions are dictated by state policy or contracting requirements; however, plans also have some flexibility to design payment and delivery systems and structure enrollees’ experiences using their coverage. To understand how Medicaid managed care plans approach access to care and the challenges they face in ensuring such access, the Kaiser Family Foundation conducted a survey of plans in 2017.