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Medicare’s Role in Health-Care Payment Reform

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman explores whether Secretary Burwell’s announcement this week about Medicare’s payment reform initiative is another sign that the public sector is becoming the engine driving payment and delivery reform. All previous columns by Drew Altman are available online.

Medicare Spending Peaks at Age 96  

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses the implications of a Kaiser finding: per capita Medicare spending peaks at age 96, and the main reason is not end-of-life care. All previous columns by Drew Altman are available online.

Awaiting New Medicaid Managed Care Rules: Key Issues to Watch

More than half of all Medicaid beneficiaries now receive their services in risk-based managed care plans, and states’ use of managed care is expanding. States operate their own Medicaid managed care programs within federal rules and requirements. The federal regulations were last updated in 2002 and a new proposed rule is expected in Spring 2015. This brief identifies key issues in the regulation and discusses how CMS might address them.

Key Findings on Medicaid Managed Care: Highlights from the Medicaid Managed Care Market Tracker

This report highlights 10 key findings on the Medicaid managed care market, based on analysis of data included in the Kaiser Family Foundation’s Medicaid Managed Care Market Tracker. The findings provide a partial profile of the Medicaid MCO market nationally and by state. They also illuminate the involvement of large, multi-state health insurance companies in the Medicaid market and the participation of these firms in other markets as well, including the managed long-term services and supports market, the new ACA marketplaces, and the Medicare Advantage market. Finally, these selected highlights serve to illustrate the array of ways the Tracker can be used to understand more about the Medicaid managed care market and its place in the broader market.

The State Innovation Models (SIM) Program: An Overview

This fact sheet provides an overview of the Center for Medicare and Medicaid Innovation (Innovation Center)’s State Innovation Models (SIM) initiative. It focuses on the delivery system and payment approaches that Model Testing states are taking and discusses what SIM means for Medicaid. Six states – Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont — received Model Testing awards to implement and test their Innovation Plans over 42 months.

Medicaid in an Era of Health & Delivery System Reform: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2014 and 2015

This report provides an in depth examination of the changes taking place in state Medicaid programs across the country. The findings in this report are drawn from the 14th 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), with the support of the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2014 and those planned for implementation in FY 2015 based on information provided by the nation’s state Medicaid Directors. Key areas covered include changes in eligibility and enrollment, delivery systems, provider payments and taxes, benefits, pharmacy programs, program integrity and program administration.

States Expanding Medicaid Under the Affordable Care Act Expect 18% Enrollment Growth in Fiscal Year 2015, With Federal Funds Picking Up Most of the Cost

States expect the number of people enrolled in Medicaid will increase an average of 13.2 percent across the country in state fiscal year 2015 (which runs through June in most states), showing the early effects of the first full year of Affordable Care Act implementation, according to the 14th annual 50-State Medicaid budget survey by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU).

Mapping Medicaid Delivery System and Payment Reform

This interactive provides state-by-state data on Medicaid delivery system and payment reform initiatives. Users can track state Medicaid managed care, patient-centered medical home (PCMH), Health Home, Accountable Care Organization (ACO), and Delivery System Reform Incentive Payment (DSRIP) waiver activity.

Medicaid 101: What You Need To Know

With some states grappling over whether to expand Medicaid, and Congress facing big decisions about the future of the Children’s Health Insurance Program (CHIP), this briefing reviewed the basics about both programs, and discuss current issues. Co-hosted by the Kaiser Family Foundation and the Alliance for Health Reform, KFF’s Diane Rowland and Ed Howard of the Alliance moderated the discussion.

Key Themes From Delivery System Reform Incentive Payment (DSRIP) Waivers in 4 States

Building on an earlier brief that provided an overview of the components of DSRIP waivers, this analysis relied upon interviews with stakeholders to identify emerging trends and themes from DSRIP waivers in four states – California, Massachusetts, New York and Texas. It highlights that DSRIP waivers are spurring major change in relationships among providers; allowing providers to launch new initiatives aimed at improving care and reducing costs; and fostering a stronger focus on the social service needs of Medicaid beneficiaries. At the same time, the rapid pace of implementation is straining the ability of stakeholders to keep pace, including consumer advocates who are hard-pressed to track and respond to the DSRIP-driven changes that are fundamentally re-shaping the way that care is delivered to Medicaid beneficiaries.

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.