An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees April 1, 2012 Issue Brief Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans…
Current and Emerging Issues in Medicaid Risk-Based Managed Care: Insights from an Expert Roundtable September 1, 2012 Issue Brief Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs. Managed care enrollment may grow more rapidly as states work with the Centers for…
Faces of the Medicaid Expansion: Experiences and Profiles of Uninsured Adults Who Could Gain Coverage November 1, 2012 Issue Brief These two papers provide insight into how state decisions to expand Medicaid under the Affordable Care Act are likely to impact people. Based on focus groups and interviews conducted in Cincinnati, Houston, Las Vegas and Tampa with uninsured adults who could be eligible for the Medicaid expansion in 2014, these…
Article and Policy Forum Examine Medicare, Health Reform and the Challenges Facing People With Disabilities September 8, 2010 Event Wednesday, Sept. 8, the Foundation held a policy workshop examining Medicare, health reform and the challenges facing people with disabilities. Younger Medicare beneficiaries with disabilities are much more likely than seniors in the program to report problems accessing and paying for needed medical services, Kaiser Family Foundation researchers report in…
Medicare Spending and Use of Medical Services for Beneficiaries in Nursing Homes and Other Long‐Term Care Facilities: A Potential for Achieving Medicare Savings and Improving the Quality of Care September 30, 2010 Report Medicare Spending and Use of Medical Services for Beneficiaries in Nursing Homes and Other Long‐Term Care Facilities: A Potential for Achieving Medicare Savings and Improving the Quality of Care This report documents the relatively high rates of hospital stays, emergency room visits and skilled nursing facility admissions among long-term care…
Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS September 8, 2015 Issue Brief This issue brief compares the financial alignment demonstrations for beneficiaries who are dually eligible for Medicare and Medicaid in states that have memoranda of understanding approved by the Centers for Medicare and Medicaid Services.
Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders July 25, 2013 Issue Brief This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.
10 Things About Long-Term Services and Supports (LTSS) September 15, 2022 Issue Brief In 2020, an estimated 5.8 million people used paid long-term services and supports (LTSS) delivered in home and community settings and 1.9 million used LTSS delivered in institutional settings.
Who Uses Medicaid Long-Term Services and Supports? December 14, 2023 Issue Brief This analysis examines the characteristics of Medicaid enrollees who use Medicaid long-term services and supports (LTSS), how enrollees who use LTSS differ from those who do not use these services, and how enrollees who use different types of LTSS differ from each other.
Individuals with Special Needs and Health Reform: Adequacy of Health Insurance Coverage August 30, 2009 Issue Brief This issue brief examines the health care needs and health costs of individuals with special health challenges, focusing on those with low-to-moderate incomes. It finds that even under a benefit package more generous than most offered in the private insurance market, individuals and families can face significant gaps in coverage…