This document summarizes the comprehensive 2010 health reform law, often called the Affordable Care Act or ACA, including changes made to it by subsequent legislation, with a focus on provisions to expand coverage, control costs, and improve delivery systems.
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2013 will be a historic year for Medicaid with the implementation of major provisions to expand coverage and streamline enrollment in the Affordable Care Act (ACA) less than a year away, a surge in activity around care delivery reforms that seek to improve care and potentially reduce costs, and the…
This fact sheet provides a brief overview of Wisconsin’s BadgerCare Plus Program, a three-year-old initiative that merged the state’s three distinct Medicaid programs for children, parents and pregnant women into a single comprehensive health coverage program. It also expanded eligibility to provide near-universal coverage for children and greater coverage for…
The nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design…
This background paper examines various aspects of the Medicaid program that can expand access to home and community-based services (HCBS) and rebalance long-term care spending in favor of HCBS. As a result of the long-standing requirement that states cover facility-based care, the majority of Medicaid long-term care (LTC) expenditures historically…
An integral component of Colorado Medicaid’s coordinated care initiative, the Accountable Care Collaborative, is the Statewide Data Analytics Contractor (SDAC), which is responsible for providing actionable data through a web portal to primary care providers and regional care collaborative organizations. The metrics and tools the SDAC provides undergird the effort to drive improvement in care management and individual and community health, and support the accountable care model.
This study examines quality among health centers relative to Medicaid managed care organizations (MCOs). Chronic care quality among health centers is high; gaps in women’s preventive care are a concern. Lower-performing health centers have very high uninsured and homeless rates. The expansion of Medicaid and private insurance under the ACA may foster gains in health center quality performance.
Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS
This brief summarizes 15 states’ preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service…
This short cartoon explains the problems with the current health care system, the health reform changes that are happening now, and the big changes coming in 2014 as part of the Affordable Care Act (ACA). You can view the video on our site and it is also available on YouTube.
Although many people require treatment for both physical and behavioral health conditions, our physical and behavioral health systems typically operate independently, without coordination. Medicaid has a significant stake in addressing this issue because physical and behavioral health comorbidity rates among beneficiaries are high. This brief examines five promising approaches currently underway in Medicaid to better integrate physical and behavioral health care.