Most states today rely heavily on risk-based managed care organizations (MCOs) to serve Medicaid beneficiaries. This Data Note discusses the current role of managed care in Medicaid and examines differences in managed care growth between states that expanded Medicaid to low-income adults under the Affordable Care Act (ACA) and states that did not expand Medicaid.
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This Issue Brief describes the Medicare Hospital Readmission Reduction Program (HRRP), which penalizes hospitals that have relatively higher readmission rates, analyzes the impact of this program on Medicare patients and hospitals, and discusses several issues that have been raised regarding its implementation.
Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states considerable flexibility in how they operate their programs, beyond what is available under current law, and can have a significant impact on program financing. This brief answers key questions about Section 1115 waiver authority, the current landscape of demonstration waivers and what to watch going forward.
There is evidence that supportive housing can contribute to improved outcomes for people experiencing homelessness or at risk of homelessness. It can also advance community integration of seniors and people with disabilities. Medicaid does not pay for room and board, but it can pay for many housing-related services for Medicaid beneficiaries. This issue brief discusses how Medicaid can support integrated strategies and profiles three initiatives that illustrate different approaches to linking Medicaid and supportive housing.
What Are the Implications of Repealing the Affordable Care Act for Medicare Spending and Beneficiaries?
The 2010 Affordable Care Act (ACA) included many provisions affecting the Medicare program and the 57 million seniors and people with disabilities who rely on Medicare for their health insurance coverage. This brief explains the Medicare provisions in the ACA and explores the implications for Medicare and beneficiaries of repealing these provisions.
As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a…
Payment and Delivery System Reform in Medicare: A Primer on Medical Homes, Accountable Care Organizations, and Bundled Payments
This primer providers an overview of certain delivery system reform models that are being examined in traditional Medicare, and explains model goals, financial incentives, potential beneficiary implications, and results so far with respect to Medicare spending and care quality. The primer discusses accountable care organizations, medical homes and bundled payments.
Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017
This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings in this report are drawn from the 16th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2016 and those implemented or planned for FY 2017 based on information provided by the nation’s state Medicaid directors. Key areas covered include changes in eligibility and enrollment, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, and covered benefits (including prescription drug policies).
50-State Survey Finds Slower Growth in Total Medicaid Spending Nationally in FY 2016 and Projected for FY 2017 as Earlier Increases from the Affordable Care Act’s Coverage Expansions Taper Off
After record increases in fiscal year 2015, growth in Medicaid enrollment and total Medicaid spending nationally slowed substantially in FY 2016 and are projected to continue to slow in FY 2017 as the initial surge of enrollment under the Affordable Care Act’s coverage expansions tapered off, according to the 16th annual 50-state…
The 16th Annual Kaiser 50-State Medicaid Budget Survey: Slowing Growth and Evolving Policies at a Forum with the National Association of Medicaid Directors
At 9:30 a.m. ET on Thursday, Oct. 13, the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) released Kaiser’s 16th annual 50-state Medicaid budget survey for state fiscal years 2016 and 2017. Kaiser and the National Association of Medicaid Directors (NAMD) held a joint briefing to discuss key…