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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…

Performance Measurement Under Health Reform: Proposed Measures For Eligibility and Enrollment Systems and Key Issues and Trade-offs to Consider

The adoption of new eligibility and enrollment requirements under the Affordable Care Act (ACA) provides states and the federal government an important opportunity to implement a meaningful set of performance measures for eligibility and enrollment systems. Performance measures could be used at the federal level to assess state performance in…

The Right Care at the Right Time: Are Retail Clinics Meeting a Need?

The Alliance for Health Reform and WellPoint, Inc. discuss the role of urgent care centers and retail clinics emerging within the health care system. Panelists will explore such questions as: Can savings and improved access to care be produced through alternative care settings? Will these settings reduce emergency room use…

Trends in the Use of Hospital and Provider Quality Ratings

With a renewed emphasis on health care quality driven by the Affordable Care Act, this polling data note examines historical trends in Americans’ reliance on quality ratings and how their perceptions have changed over time. Data Note (.pdf)

Managing a High Performing Medicaid Program

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.

Quality of Care in Community Health Centers and Factors Associated with Performance

This study examines quality among health centers relative to Medicaid managed care organizations (MCOs). Chronic care quality among health centers is high; gaps in women’s preventive care are a concern. Lower-performing health centers have very high uninsured and homeless rates. The expansion of Medicaid and private insurance under the ACA may foster gains in health center quality performance.

The Future of Medicare Advantage: Are We on the Right Path?

This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act’s reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.

What is Medicaid’s Impact on Access to Care, Health Outcomes, and Quality of Care? Setting the Record Straight on the Evidence

Medicaid now covers more than 1 in every 5 Americans, and millions of uninsured individuals will become newly eligible for Medicaid under the ACA. Considering Medicaid’s large and growing coverage role, an evidence-based assessment of the program’s impact on access to care, health outcomes, and quality of care is of major interest. This brief takes a look at what the research literature shows regarding the difference Medicaid makes.