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.
- state & global data
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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.
Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California
This brief examines how health service providers, plan administrators, and community-based organizations in Contra Costa, Kern, and Los Angeles Counties experienced the transition of Medi-Cal-only seniors and persons with disabilities (SPDs) to managed care as part of the state’s “Bridge to Reform” Medicaid waiver. Findings presented may inform similar transitions of high-need beneficiaries in other states and coverage expansions in 2014 under the Affordable Care Act.
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.
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.
Amid increasing state and national interest in using managed care delivery models for Medicaid beneficiaries, the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) hosted a public briefing on Tuesday, June 25, 2013 to provide information on recent transitions from fee-for-service to managed care, and to discuss their…
This brief examines the role of Medicare and Medicaid in the lives of dually eligible beneficiaries – low-income seniors and younger adults with disabilities who are eligible for both programs – through personal profiles. It includes a glossary of eligibility and service delivery system terms and state-level enrollment and expenditure data for dual eligibles.
How the Changing Health Care Marketplace Affects Coverage and Access to Reproductive Health A fact sheet, Q&A and resource list prepared for a media briefing held in New York on March 27, 1996. The purpose of the briefing was to respond to questions about how reproductive health services are currently…
Medicare Health Plans and Dually Eligible Beneficiaries: Industry Perspectives on the Current and Future Market
As federal and state governments advance efforts to better coordinate care and reduce costs for people dually eligible for both Medicare and Medicaid benefits, this brief examines how insurers now serving these markets view the opportunities and challenges, including a look at Medicare Advantage Special Needs Plans.
This report presents state-by-state policies on coverage of key areas in reproductive health for low-income women, including contraception, preconception care, screenings for sexually transmitted diseases and coverage within special state Medicaid family planning programs.