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…
Featured Dual Eligible Resources
Nearly 355,000 Dual Eligible Beneficiaries Are Enrolled in Capitated Financial Alignment Demonstrations in 9 States, as of June 2015
This chart and a related fact sheet show enrollment in the capitated financial alignment demonstrations for beneficiaries who are eligible for both Medicare and Medicaid. Nearly 355,000 seniors and non-elderly adults with disabilities are enrolled in these demonstrations in 9 states as of June 2015.
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Related Dual Eligible Resources
- Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS
- Early Insights From Ohio’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
- Early Insights from One Care: Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
- Early Insights from Commonwealth Coordinated Care: Virginia’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
- Dual Eligible Demonstrations: The Beneficiary Perspective
- Affordable Care Act Provisions Relating to the Care of Dually Eligible Medicare and Medicaid Beneficiaries
This slide shows how many people are covered by both Medicare and Medicaid.
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Massachusetts and Ohio: Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries Compared
The Centers for Medicare and Medicaid Services (CMS) has finalized memoranda of understanding (MOUs) with Massachusetts and Ohio to test a capitated financial alignment model to integrate care and align financing for people who are dually eligible for Medicare and Medicaid in 2013. CMS also has signed an MOU with…
This paper contains short profiles four Medicaid beneficiaries who have been helped by Money Follows the Person demonstration programs in Michigan and Washington state.
Long-Term Services and Supports in the Financial Alignment Demonstrations for Dual Eligible Beneficiaries
This issue brief compares the treatment of LTSS in the seven approved capitated financial alignment demonstrations for dual eligible beneficiaries.
This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to…
One year into initial enrollment in the Medicare-Medicaid financial alignment demonstrations for dual eligible beneficiaries, some initial insights are beginning to emerge. This policy insight highlights key challenges and trends emerging in states’ demonstrations.
Demonstrations to Improve the Coordination of Medicare and Medicaid for Dually Eligible Beneficiaries: What Prior Experience Did Health Plans and States Have with Capitated Arrangements?
This report examines the Center for Medicare and Medicaid Services (CMS) financial alignment demonstration for beneficiaries dually eligible for Medicare and Medicaid, with a focus on the extent to which participating states and health plans have prior experience with capitated managed care arrangements under Medicare or Medicaid, and specifically for this population. Under these capitated financial alignment demonstrations, health plans contract with the state and CMS (a three-way contract) to provide both Medicare and Medicaid benefits to dually eligible beneficiaries. These demonstrations aim to improve the quality of care and the coordination of benefits for people dually eligible for Medicare and Medicaid. The report finds considerable variation in the experience of states and health plans participating in these demonstrations, and discusses the potential implications for beneficiaries and plan oversight.
This issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.
Health Plan Enrollment in the Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries
This fact sheet provides a snapshot of enrollment in the capitated financial alignment demonstrations by state for beneficiaries who are dually eligible for Medicare and Medicaid as of June, 2015.
Serving Low-Income Seniors Where They Live: Medicaid’s Role in Providing Community-Based Long-Term Services and Supports
Using the 2011 National Health and Aging Trends Study (NHATS), this brief first examines the need for long-term services and supports (LTSS) among seniors living in the community. It then studies health status, mobility limitations, and housing characteristics of seniors living in the community with an LTSS need.