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The Henry J. Kaiser Family Foundation

Key Themes in Capitated Medicaid Managed Long-Term Services and Supports Waivers

This issue brief analyzes key themes in 19 capitated § 1115 and § 1915(b)/(c) Medicaid managed long-term services and supports (MLTSS) waivers approved to date by the Centers for Medicare and Medicaid Services (CMS) with a focus on covered populations and services, provisions aimed at expanding beneficiary access to HCBS, beneficiary protections, and quality measurement and oversight.

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The Henry J. Kaiser Family Foundation

Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations

This report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.

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El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!

En Español El seguro de salud, explicado: ¡los YouToons lo tienen cubierto! desglosa conceptos de seguros como primas, deducibles y redes de proveedores.  Explica cómo las personas pagan por su cobertura y cómo obtener cuidado médico y medicamentos recetados con distintos tipos de seguros de salud, incluyendo HMOs y PPOs.…

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YouToons: Health Insurance Explained

Health Insurance Explained: The YouToons Have it Covered

In this five-minute animated video, the YouToons help consumers understand their health insurance through fun, easy-to-understand explanations and scenarios. This cartoon serves as a tutorial for consumers and organizations. The YouToons previously appeared in the 2010 animated movie, “Health Reform Hits Main Street” and the 2013, “The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act.”

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The Henry J. Kaiser Family Foundation

Connecting Consumers to Coverage: Lessons Learned from Assisters for Successful Outreach and Enrollment

This brief highlights the experiences of Navigators and other Marketplace consumer assistance programs under the Affordable Care Act (Obamacare) in conducting outreach and providing enrollment assistance during the ACA’s first open enrollment period. It provides insight into the outreach and enrollment strategies the assisters developed and identifies the keys to successfully overcoming the challenges of the first year. These insights are based on findings from focus groups with assisters in four cities: Miami, Florida; Houston, Texas; Raleigh, North Carolina; and Cleveland, Ohio.

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The Henry J. Kaiser Family Foundation

Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.

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The Henry J. Kaiser Family Foundation

JAMA Forum: A To-Do List for the New CEO of the Federal Health Insurance Marketplace

Larry Levitt’s July 2014 post at the JAMA Forum assesses early indications of how well the Affordable Care Act is working.

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The Henry J. Kaiser Family Foundation

JAMA Forum: Surprise, Surprise

Larry Levitt’s February 2016 post explains how “surprise medical bills” — unanticipated charges for out-of-network care – can happen. It describes some government approaches to the issue and outlines the challenges to protecting consumers. The post is now available at The JAMA Forum.

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The Henry J. Kaiser Family Foundation

Surprise Medical Bills

This brief explores the problem of “surprise medical bills” — charges arising when an insured individual inadvertently receives care from an out-of-network provider. It reviews studies on the extent of the issue, including Kaiser Family Foundation polling data, and outlines state and federal policy responses, including rules and proposed rules for Medicare and plans in Affordable Care Act marketplaces.

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The Henry J. Kaiser Family Foundation

In N.Y. Policy on Out-of-Network Medical Bills, a Model for Other States?

In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses surprise bills for out-of-network care, and New York state’s solution to the problem.

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The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.