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Statewide Medicaid Managed Care Demonstrations under Section 1115 of the Social Security Act:

A Review of the Waiver Applications, Letters of Approval and Special Terms and ConditionsThis background paper provides a summary of the key features of the Medicaid 1115 waivers that have been approved, proposed, implemented and conditionally rejected. This July version updates Medicaid 1115 Demonstration Waivers: Approved and Proposed Activities as…

Medicaid Innovations: Can Managed Care Cut Costs and Improve Value?

A number of states have expressed interest in expanding managed care approaches within their Medicaid programs. While managed care may present an opportunity for better delivery of care, it presents challenges within certain populations and geographic areas. How many states are planning Medicaid managed care expansions? What impact would these…

An Overview of Recent Section 1115 Medicaid Demonstration Waiver Activity

This brief summarizes and examines the implications of recent Section 1115 Medicaid waiver activity. Section 1115 waivers provide states flexibility to test new approaches in Medicaid that differ from federal program rules and can have significant impacts for beneficiaries, providers, and states. While recent waivers and waiver proposals vary in…

Emerging Medicaid Accountable Care Organizations: The Role of Managed Care

This brief examines efforts by a number of states to set up Accountable Care Organizations (ACOs) within their Medicaid programs. An ACO is a provider-run organization in which participating providers are collectively responsible for the care of an enrolled population, and may share in any savings associated with improvements in…

California and Texas: Section 1115 Medicaid Demonstration Waivers Compared

This fact sheet compares and contrasts key provisions of the California and Texas Section 1115 Medicaid demonstration waivers. The Texas waiver, approved in December 2011, is modeled, in part, on the California waiver, which has been underway in that state since November 2010. Both waivers affect hundreds of thousands of…

A Profile of Medicaid Managed Care Programs in 2010: Findings from a 50-State Survey

Most Medicaid beneficiaries nationally are enrolled in some form of managed care, and, with current budget pressure and health reform on the horizon, states are expected to increase their reliance on managed care to deliver services in their Medicaid programs. This 50-state survey, conducted by the Kaiser Commission on Medicaid…

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…

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…