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Demonstrations to Improve the Coordination of Medicare and Medicaid for Dually Eligible Beneficiaries: What Prior Experience Did Health Plans and States Have with Capitated Arrangements?

This report examines the Center for Medicare and Medicaid Services (CMS) financial alignment demonstration for beneficiaries dually eligible for Medicare and Medicaid, with a focus on the extent to which participating states and health plans have prior experience with capitated managed care arrangements under Medicare or Medicaid, and specifically for this population. Under these capitated financial alignment demonstrations, health plans contract with the state and CMS (a three-way contract) to provide both Medicare and Medicaid benefits to dually eligible beneficiaries. These demonstrations aim to improve the quality of care and the coordination of benefits for people dually eligible for Medicare and Medicaid. The report finds considerable variation in the experience of states and health plans participating in these demonstrations, and discusses the potential implications for beneficiaries and plan oversight.

The Ryan White Program and Insurance Purchasing in the ACA Era: An Early Look at Five States

This issue brief examines the role that the Ryan White Program has played in helping HIV positive clients purchase insurance coverage from both a historical and an Affordable Care Act (ACA) era perspective. The ACA era analysis focuses on activities in five states during the first open enrollment period and looks specifically at insurance purchasing through the health insurance marketplaces. The states analyzed are California, Florida, Georgia, New York, and Texas.

Where Are States Today? Medicaid and CHIP Eligibility Levels for Adults, Children, and Pregnant Women

This fact sheet provides an overview of eligibility levels for parents, other non-disabled adults, children, and pregnant women in Medicaid and CHIP. The data are based on eligibility levels reported by states as of January 2015, updated to reflect state Medicaid expansion decisions as of April 2015. The findings highlight Medicaid’s expanded role for low-income adults under the Affordable Care Act (ACA) and its continued role as a primary source of coverage for children and pregnant women.

The Impact of the Coverage Gap in States not Expanding Medicaid by Race and Ethnicity

The Affordable Care Act (ACA) expansion of Medicaid to adults with incomes at or below 138% of the federal poverty level (FPL) effectively became a state option following the Supreme Court decision, creating a “coverage gap” for many poor uninsured adults in states that do not expand Medicaid. This brief examines the coverage gap by race and ethnicity.

Recent Trends in Medicaid and CHIP Enrollment as of January 2015: Early Findings from the CMS Performance Indicator Project

Building on earlier work examining the Performance Indicator Project, this is an updated analysis examining recent trends in Medicaid and CHIP eligibility and enrollment. As of January 2015, 70.0 million people were enrolled in Medicaid or CHIP. Nearly two-thirds of enrollees resided in states that have implemented the Medicaid expansion. Between Summer 2013 and January 2015, there was a net increase of nearly 11.2 million people enrolled in Medicaid and CHIP; states that expanded Medicaid experienced significantly greater net Medicaid and CHIP enrollment growth than states that have not expanded. Children account for a greater share of total Medicaid and CHIP enrollment in nearly all states that have not expanded Medicaid compared to states that have expanded.

The Health-Care Enrollment Story Is in the States

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines the variation among states beneath the national Affordable Care Act’s Marketplace enrollment numbers released by the U.S. Department of Health and Human Services. All previous columns by Drew Altman are available online.

The Health-Care Enrollment Story Is in the States

In this column for The Wall Street Journal’s Think Tank, Drew Altman examines the variation among states beneath the national Affordable Care Act’s Marketplace enrollment numbers released by the Department of Health and Human Services.

New Kaiser 50-State Survey Provides Data on States’ Medicaid and Children’s Health Insurance Program Eligibility Levels and Enrollment, Renewal and Cost-Sharing Policies as of January 2015

A new survey from the Kaiser Family Foundation provides a comprehensive look at where states stand with their Medicaid and Children’s Health Insurance Program (CHIP) eligibility levels and enrollment, renewal and cost-sharing policies as of January 2015, one year into implementation of the Affordable Care Act’s major coverage provisions. The…

Web Briefing: The Medicaid Managed Care Market Tracker

More than half of the nation’s 67.9 million Medicaid beneficiaries now receive their health care in comprehensive managed care organizations (MCOs) – and the number and share are growing. As states expand their use of Medicaid managed care, the Kaiser Family Foundation has launched a new interactive tool to enhance…