This brief outlines Medicaid’s role for Medicare beneficiaries. It describes the role that Medicaid plays for 10 million Medicare beneficiaries to help inform upcoming debates about proposals to restructure Medicaid financing in ways that could reduce federal funding.
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This issue brief describes the role that Medicaid plays in covering a wide range of medical and long-term care services, many of which are not covered or limited under private insurance, and making coverage affordable for many children with special health care needs and their families.
Medicaid Section 1115 Managed Long-Term Services and Supports Waivers: A Survey of Enrollment, Spending, and Program Policies
This report presents findings from a state survey about Medicaid Section 1115 capitated managed long-term care services and supports waiver enrollment, spending, and program policies for seniors and people with disabilities as of 2015.
Medicaid, the nation’s public health insurance program for people with low income, covers 1 in 5 Americans, including many with complex and costly health care needs. Medicaid is also the primary source of long-term care coverage in the U.S. State and federal Medicaid dollars provide significant financing for our health care system and finance over 16% of personal health spending. This primer outlines fundamentals of the Medicaid program.
This report summarizes the key national trends to emerge from the latest (2013) participant and expenditure data for the three main Medicaid HCBS programs: (1) the mandatory home health services state plan benefit, (2) the optional personal care services state plan benefit, and (3) optional § 1915 (c) HCBS waivers. It also highlights findings on 2015 eligibility, enrollment, and provider reimbursement policies.
Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017
This report provides an in-depth examination of the changes taking place in Medicaid programs across the country. The findings in this report are drawn from the 16th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA), in collaboration with the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2016 and those implemented or planned for FY 2017 based on information provided by the nation’s state Medicaid directors. Key areas covered include changes in eligibility and enrollment, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, and covered benefits (including prescription drug policies).
This fact sheet describes how seniors qualify for Medicaid long term services and supports (LTSS), what LTSS covers, how much Medicaid spends on LTSS, and current policy issues.
For 15 years, KCMU and HMA have conducted annual surveys of Medicaid programs across the country. The NAMD has formally collaborated on this project since 2014. This brief provides a look back at the enrollment and spending trends as well as the multitude of policy actions taken by states across key areas: eligibility and application processes; provider rates and taxes; benefits, pharmacy and long-term care since as well as highlighting more recent data on managed care and delivery system reforms collected as part of this annual survey. Looking ahead, the survey will continue to capture the evolution of the Medicaid program with a focus program changes during economic cycles as well as innovations in payment and delivery system reform.
On April 21, 2016, the Centers for Medicare & Medicaid Services (CMS) issued final regulations that revise and significantly strengthen existing Medicaid managed care rules. In keeping with states’ increasingly heavy reliance on managed care programs to deliver services to Medicaid beneficiaries, including many with complex care needs, the regulatory framework and new requirements established by the final rule reflect increased federal expectations regarding fundamental aspects of states’ Medicaid managed care programs.
This issue brief draws on features of the various existing Medicaid home and community-based services (HCBS) programs to identify key policy questions raised by initiatives to streamline Medicaid HCBS, ameliorate institutional bias, and improve administrative simplification.