Explaining Health Reform: Medicare and the New Independent Payment Advisory Board April 29, 2010 Issue Brief This brief describes how the new board created under the 2010 health reform law is expected to limit the growth in Medicare spending over time. Starting in 2014, if projected per capita Medicare spending exceeds targets set in the law, the board must recommend ways to reduce Medicare spending, while…
Explaining Health Reform: Key Changes in the Medicare Advantage Program April 29, 2010 Issue Brief This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring…
State Budgets Under Federal Health Reform: The Extent and Causes of Variations in Estimated Impacts February 1, 2011 Issue Brief This analysis examines the potential costs and savings that the health reform law may generate for state budgets, a topic of great interest at a time when states continue to struggle with tight budgets in the wake of the recession. The analysis seeks to explain why recent state estimates of…
Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries September 30, 2012 Issue Brief 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…
State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS September 30, 2012 Report 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…
Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs January 26, 2009 Perspective In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the…
Explaining Health Care Reform: How Might a Reform Plan Be Financed? July 1, 2009 Issue Brief One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said…
To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents September 30, 2010 Report To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents This report explores factors that appear to drive relatively high rates of hospitalizations, based on interviews with doctors, nursing home staff and families in four cities. Key factors include liability concerns, limited onsite staff capabilities, difficulty reaching…
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…
A Focus Group with Medicaid Directors: As FY 2012 Ends, Looking Toward FY 2013 June 1, 2012 Report This report is based on a focus group discussion in May 2012 with the Executive Board of the National Association of Medicaid Directors (NAMD) and other leading Medicaid directors. The group of nine directors reflected perspectives from various regions of the country. The discussion focused on state fiscal conditions, Medicaid…