California’s Medicaid program, Medi-Cal, is the largest state Medicaid program in the nation, insuring almost one-third of Californians. For several decades, Medi-Cal has been transitioning from a fee-for-service (FFS) system to risk-based managed care, and more than three-quarters of all Medi-Cal beneficiaries, including low-income children, adults, seniors, and people with disabilities, are now enrolled in managed care plans. As other state Medicaid programs increase their reliance on risk-based managed care, a review of California’s transition is both timely and illustrative. This issue brief provides an overview of the evolution of Medi-Cal managed care, key issues, and lessons for managed care programs in other states.
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Geographic Variation in U.S. Medicare Per Capita Spending and Spending Growth Rates by County, 2007-2013
This interactive map displays three measures of county-level Medicare per capita spending: Unadjusted Medicare spending per beneficiary in 2013; Medicare spending per beneficiary adjusted for prices and health status in 2013; and Medicare per beneficiary spending growth rates for 2007-2013.
The Latest on Geographic Variation in Medicare Spending: A Demographic Divide Persists But Variation Has Narrowed
This report uses the most current data available to analyze Medicare per beneficiary spending, by county, in 2013; the growth in Medicare per beneficiary spending between 2007 and 2013, by county; and the extent to which geographic variation in Medicare per beneficiary spending has increased or decreased over time. The analysis finds that beneficiaries living in counties with relatively high Medicare per beneficiary spending tend to be sicker and poorer than beneficiaries living in lower-spending counties and that the gap between high and low-spending counties narrows but does not close after adjustments are made for differences in prices and beneficiaries’ health status. The analysis also shows that the amount of variation between the highest- and lowest-spending counties appears to have narrowed in recent years, raising questions as to whether these changes are due to specific shifts in payment policy. An interactive U.S. map showing county-level Medicare spending is also available.
This interactive zip code tool and map displays enrollment in the Health Insurance Marketplaces as a share of the potential market in small geographic areas across the country.
This September 2014 Visualizing Health Policy Infographic examines the role of private plans, such as HMOs and PPOs, in Medicare. These Medicare Advantage plans offer an alternative to traditional Medicare and provide all benefits covered under Medicare Parts A and B, and often Part D. The infographic includes data on Medicare Advantage penetration across the country. It shows the concentration of enrollment among a small number of firms and affiliates, and displays the extent to which Medicare pays more for Medicare Advantage enrollees than for beneficiaries in fee for service Medicare, on average, and that the payment differential is declining
This brief highlights estimates from the Urban Institute’s ACS-HIPSM on the magnitude and composition of Medicaid enrollees and the uninsured after full implementation of the Affordable Care Act (ACA), including the Medicaid expansion. Both state and local level estimates highlight the geographic variation.