This issue brief provides an overview of California’s “Bridge to Reform” Medicaid Demonstration Waiver, which was approved in 2010 and will make up to roughly $8 billion in federal Medicaid matching funds available to California over a five-year period to expand coverage to low-income uninsured adults and preserve and improve…
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Washington’s Managed FFS Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries
Washington is the first state to sign a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test a managed fee-for-service (FFS) financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, beginning on April 1, 2013. Washington’s managed FFS demonstration uses…
This fact sheet provides an overview of the Medicaid program’s increasing reliance on managed care to deliver services.Fact Sheet
A new background report sums up how multiple trends have led to a situation where safety net hospitals are feeling more financial pressure and are challenged to subsidize the unprofitable care of theuninsured.Background Paper For a more extensive discussion read our larger report from the same study.
Medicaid Managed Care for Dual Eligibles: Case Studies of Programs in Georgia, Minnesota, and Pennsylvania
This report, a companion piece to publication #2246, presents detailed case studies of the managed care programs that enroll dual eligibles in three states: Georgia, Minnesota and Pennsylvania.Report
Protection For Consumers In Managed Care Plans: A Comparison Of Medicare, Medicaid and the Private Insurance Market
This policy paper describes key requirements of consumer protection regulation under Medicare, Medicaid and federal and state laws as they apply to private health insurance. These include choice and availability of plans, disclosure of information, marketing, access, quality, and the grievance and appeals process. The discussion highlights differences and similarities…
An updated study follows trends in commercial health plan participation in Medicaid managed care and includes new analyses on the performance of Medicaid-dominated and commercial plans on measures of effective care and access to care, and on the extent to which plans restrict their Medicaid service areas.
A new policy brief provides a description of the Section 1115 law, its history, and an overview of how it plays a role in the restructuring of Medicaid and SCHIP.
Public Health in a Changing Health Care System: Linkages Between Public Health and MCOs In the Treatment and Prevention of STDs
Public health agencies and managed care organizations share responsibility for the health of the populations they serve. Their relationships are particularly important in the area of STDs. This study analyzes the evolving relationships between managed care organizations and public health agencies in how they manage the prevention, treatment, and tracking…
This report updates an earlier study of Oregon'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 have affected health insurance coverage and access to care for the…