As many states expand their use of managed care in Medicaid, a growing number of beneficiaries with disabilities are being enrolled in risk-based managed care arrangements for at least some of their care. Further growth in managed care is expected in 2014, when the Affordable Care Act expands Medicaid eligibility…
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We recently wrote about the different ways in which the Affordable Care Act (ACA) changes pathways to health insurance coverage for people with HIV, and chronicled these specifics, as well as several outstanding questions, in a policy brief. As we noted, among the many provisions of the ACA designed to…
This report updates a 1994 case study of California's Medicaid managed care initiative. California uses three predominant managed care models in its Medi-Cal program: county organized health (COHS), geographic managed care (GMC), and the two-plan model. This case study focuses specifically on Los Angeles County's two-plan model and Orange County's…
Medicaid’s Role for the Disabled Population Under Age 65Defines the non-elderly disabled and summarizes Medicaid’s role in their health care coverage. Includes a description of enrollment requirements, benefits, spending and managed care concerns for the population.Fact Sheet
The fourth in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that states have been able to enter arrangements with plans for their S-CHIP population fairly easily.
National Perspectives on Medicaid Managed Care Report: National Perspectives on Medicaid Managed Care
Medicaid Managed Care for Persons With Disabilities: State ProfilesThis report provides state estimates of the number of Medicaid disabled enrolled in managed care and profiles these programs. It provides detailed comparative state information on enrollment, program features, rate setting, quality issues, and special enrollment features for the disabled in Medicaid…
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.
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.