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The Henry J. Kaiser Family Foundation

A Focus Group with Medicaid Directors: As FY 2012 Ends, Looking Toward FY 2013

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…

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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

Native Americans and Medicaid: Coverage and Financing Issues – Report

Native Americans and Medicaid:Coverage and Financing IssuesPrepared by Andy Schneider and JoAnn Martinez, The Center on Budget and Policy Priorities for The Kaiser Commission on the Future of MedicaidDecember 1997Table Of ContentsHighlights ii I: Background On Native American Health Care 1 II: Medicaid's Role For Native Americans 4 1. Medicaid…

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The Henry J. Kaiser Family Foundation

Managed Care and Low-Income Populations:  Four Years’ Experience with TennCare

Managed Care and Low-Income Populations: Four Years’ Experience with TennCare This report updates an earlier study of Tennessee’s experience with restructuring their Medicaid programs. It is one of a series of reports from The Kaiser/ Commonwealth Low-Income Coverage and Access Project. This project examines how changes in the Medicaid program…

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The Henry J. Kaiser Family Foundation

The Changing Medicaid Managed Care Market

Trends in Commercial Plans' ParticipationThis background paper analyzes the trends in commercial plan participation in the Medicaid market by using a database specifically designed for this purpose. It examines changes from mid-1996 to mid-1997 in the types of full-risk plans serving Medicaid Beneficiaries. It also looks at trends through mid-1998…

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The Henry J. Kaiser Family Foundation

Quick Take: Medicaid MCOs and Medical Loss Ratio (MLR) Requirements

One mechanism for ensuring that health insurance provides value to consumers for the premiums that they pay, or that others pay on their behalf, is to require insurers to meet a minimum “medical loss ratio” or MLR standard. The MLR is the share of premium revenues that an insurer or…

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The Henry J. Kaiser Family Foundation

How is the Affordable Care Act Leading to Changes in Medicaid Today? State Responses to Five New Options

This policy brief examines how states in every region have responded to five key opportunities available under the health reform law to help them prepare for the significant expansion of Medicaid in 2014. The options covered in the brief include incentives for states to get an early start on the…

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The Henry J. Kaiser Family Foundation

Financial Alignment Models for Dual Eligibles: An Update

The nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design…

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The Henry J. Kaiser Family Foundation

Decoding Medicaid Care Delivery and Financing Models: A Glossary of Widely Used Terms

As care delivery and financing models in Medicaid have multiplied, so has the terminology used to refer to them. This glossary seeks to clarify and define the terms that are widely used to describe the diverse approaches that states are taking to reform the way they organize and pay for…

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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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