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The Henry J. Kaiser Family Foundation

Washington’s Managed FFS Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013. Washington’s managed FFS demonstration uses…

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The Henry J. Kaiser Family Foundation

Massachusetts and Washington: Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared

This fact sheet examines the similarities and differences between the five-year demonstrations in Massachusetts and Washington state to integrate care and align financing for people dually eligible for Medicare and Medicaid. The states finalized memoranda of understanding (MOUs) with the Centers for Medicare and Medicaid Services in fall 2012, and…

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The Henry J. Kaiser Family Foundation

Medicaid Eligibility and Enrollment for People With Disabilities Under the Affordable Care Act: The Impact of CMS’s March 23, 2012 Final Regulations

This brief provides a short summary of Medicaid eligibility and benefits for people with disabilities today and explains how they will be affected by the ACA in light of the Centers for Medicare and Medicaid Services’ (CMS) March 23, 2012 final rule to implement the ACA provisions relating to Medicaid…

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The Henry J. Kaiser Family Foundation

The Role of Medicaid for Adults With Chronic Illnesses

This report and related fact sheets provide data on spending, utilization, and access to care among low-income nonelderly adult Medicaid beneficiaries with chronic illnesses. Four fact sheets provide detail for beneficiaries with diabetes, respiratory disease, cardiovascular disease, and behavioral health conditions The reports show that, despite relatively high prevalence of…

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The Henry J. Kaiser Family Foundation

Faces of the Medicaid Expansion: Experiences and Profiles of Uninsured Adults Who Could Gain Coverage

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…

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The Henry J. Kaiser Family Foundation

Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS’s capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will…

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The Henry J. Kaiser Family Foundation

Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries…

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The Henry J. Kaiser Family Foundation

State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS

The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of…

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The Henry J. Kaiser Family Foundation

Coverage of Preventive Services for Adults in Medicaid

This brief highlights data from a survey of coverage of 42 recommended preventive services for adults in Medicaid fee-for-service programs as of October 2010. Medicaid programs must cover preventive services for children as part of the Early Periodic Screening, Diagnosis and Treatment (EPSDT) benefit, but generally are not required to…

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The Henry J. Kaiser Family Foundation

Current and Emerging Issues in Medicaid Risk-Based Managed Care: Insights from an Expert Roundtable

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…

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