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The Henry J. Kaiser Family Foundation

Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders

This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.

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The Henry J. Kaiser Family Foundation

Managing a High Performing Medicaid Program

This report discusses key responsibilities that the federal government and states hold for managing the Medicaid program and identifies the key issues and challenges states face as they transform the way they do business and achieve key national goals. The paper relies on an extensive review of federal and state administrative responsibilities drawn from statute, regulation, and relevant literature, coupled with discussions with six current Medicaid directors.

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The Henry J. Kaiser Family Foundation

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.

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The Henry J. Kaiser Family Foundation

Key Findings on Medicaid Managed Care: Highlights from the Medicaid Managed Care Market Tracker

This report highlights 10 key findings on the Medicaid managed care market, based on analysis of data included in the Kaiser Family Foundation’s Medicaid Managed Care Market Tracker. The findings provide a partial profile of the Medicaid MCO market nationally and by state. They also illuminate the involvement of large, multi-state health insurance companies in the Medicaid market and the participation of these firms in other markets as well, including the managed long-term services and supports market, the new ACA marketplaces, and the Medicare Advantage market. Finally, these selected highlights serve to illustrate the array of ways the Tracker can be used to understand more about the Medicaid managed care market and its place in the broader market.

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The Henry J. Kaiser Family Foundation

Web Briefing: The Medicaid Managed Care Market Tracker

More than half of the nation’s 67.9 million Medicaid beneficiaries now receive their health care in comprehensive managed care organizations (MCOs) – and the number and share are growing. As states expand their use of Medicaid managed care, the Kaiser Family Foundation has launched a new interactive tool to enhance…

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The Henry J. Kaiser Family Foundation

New Interactive Data Tool Tracks Medicaid Managed Care Market

The Medicaid Managed Care Market Tracker, a new feature of the Foundation’s State Health Facts data center, provides the latest data on key dimensions of risk-based Medicaid managed care for the 39 states that contract with MCOs – these states are home to more than 90 percent of all Medicaid beneficiaries nationwide. On Thursday, December 11 at 12:30 p.m. ET, the Foundation will host an interactive web briefing with Medicaid managed care expert Julia Paradise, an Associate Director of the Foundation’s Kaiser Commission on Medicaid and the Uninsured.

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The Henry J. Kaiser Family Foundation

Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS

This issue brief compares the financial alignment demonstrations for beneficiaries who are dually eligible for Medicare and Medicaid in states that have memoranda of understanding approved by the Centers for Medicare and Medicaid Services.

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The Henry J. Kaiser Family Foundation

Awaiting New Medicaid Managed Care Rules: Key Issues to Watch

More than half of all Medicaid beneficiaries now receive their services in risk-based managed care plans, and states’ use of managed care is expanding. States operate their own Medicaid managed care programs within federal rules and requirements. The federal regulations were last updated in 2002 and a new proposed rule is expected in Spring 2015. This brief identifies key issues in the regulation and discusses how CMS might address them.

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The Henry J. Kaiser Family Foundation

Comparison of Consumer Protections in Three Health Insurance Markets: Medicare Advantage, Qualified Health Plans and Medicaid Managed Care Organizations

This report examines similarities and differences in federal consumer protection standards for Medicare Advantage (MA) plans, Qualified Health Plans (QHPs), and Medicaid Managed Care Organizations (MCOs). It focuses on rules established at the federal level, though some states have chosen to go above the federal minimums and impose additional requirements for QHPs and Medicaid MCOs.

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The Henry J. Kaiser Family Foundation

Medicaid in an Era of Health & Delivery System Reform: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2014 and 2015

This report provides an in depth examination of the changes taking place in state Medicaid programs across the country. The findings in this report are drawn from the 14th 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), with the support of the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2014 and those planned for implementation in FY 2015 based on information provided by the nation’s state Medicaid Directors. Key areas covered include changes in eligibility and enrollment, delivery systems, provider payments and taxes, benefits, pharmacy programs, program integrity and program administration.

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