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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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The Henry J. Kaiser Family Foundation

Health Homes for Medicaid Beneficiaries with Chronic Conditions

This brief profiles four states that were the first to receive federal approval to take up a state option under the Affordable Care Act to implement health homes for Medicaid beneficiaries with chronic conditions. Almost half of the 9 million people who qualify for Medicaid on the basis of disability…

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The Henry J. Kaiser Family Foundation

Medicaid and Long-Term Care Services and Supports

This updated fact sheet provides an overview of long-term care services, delivery of such services, and the large role Medicaid plays in financing long-term care. Fact Sheet (.pdf) Previous version: March 2011 (.pdf)

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The Henry J. Kaiser Family Foundation

Articles Examine Data and Issues For Expanding Integrated Care Models For Dual-Eligible Beneficiaries

As state and federal policymakers move to develop and test integrated care models for people dually eligible for Medicare and Medicaid, two new Kaiser Family Foundation articles in the June 2012 issue of Health Affairs highlight the diverse needs and challenges facing these 9 million beneficiaries, describe their current care…

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The Henry J. Kaiser Family Foundation

Health Care Use and Chronic Conditions Among Childless Adult Medicaid Enrollees in Arizona

Under the Affordable Care Act (ACA), beginning in 2014, Medicaid eligibility will expand to 133% of the federal poverty level for nearly all individuals. Arizona is one of the few states that already cover adults without dependent children in Medicaid through a longstanding Section 1115 waiver. This report, based on…

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The Henry J. Kaiser Family Foundation

Emerging Medicaid Accountable Care Organizations: The Role of Managed Care

This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs. An ACO is a provider-run organization in which participating providers are collectively responsible for the care of an enrolled population, and may share in any savings associated with improvements in…

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The Henry J. Kaiser Family Foundation

An Overview of Recent Section 1115 Medicaid Demonstration Waiver Activity

This brief summarizes and examines the implications of recent Section 1115 Medicaid waiver activity. Section 1115 waivers provide states flexibility to test new approaches in Medicaid that differ from federal program rules and can have significant impacts for beneficiaries, providers, and states. While recent waivers and waiver proposals vary in…

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The Henry J. Kaiser Family Foundation

An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees

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…

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