Vermont’s Choices for Care Medicaid Long-Term Services Waiver: Progress and Challenges As the Program Concluded Its Third Year October 31, 2008 Report Vermont's Choices for Care experiment in long-term services, created through a five-year Medicaid waiver in 2005, was designed to increase access to home and community-based services while reducing the use of institutional services and controlling overall costs. In exchange for agreeing to a federal funding cap, Vermont was able to…
Quick Take: Medicaid MCOs and Medical Loss Ratio (MLR) Requirements April 13, 2012 Fact Sheet One mechanism for ensuring that health insurance provides value to consumers for the premiums that they pay, or that others pay on their behalf, is to require insurers to meet a minimum “medical loss ratio” or MLR standard. The MLR is the share of premium revenues that an insurer or…
Vermont’s Global Commitment Waiver: Implications for the Medicaid Program April 29, 2006 Issue Brief This issue brief provides some general background on Vermont's Medicaid program and the Global Commitment waiver; answers a series of key questions about how it is designed to work; and discusses the potential implications for the state of Vermont, beneficiaries, and the Medicaid program.In the fall of 2005, Vermont secured…
The Impact of Recent Changes in Health Care Coverage for Low-Income People: A First Look at the Research Following Changes in Oregon’s Medicaid Program May 30, 2004 Issue Brief The Impact of Recent Changes in Health Care Coverage for Low-Income People: A First Look at the Research Following Changes in Oregon's Medicaid ProgramOregon recently restructured its Medicaid program through a Section 1115 waiver and other program changes, largely in response to particularly difficult state budget problems. This report summarizes…
A Case Study of the Utah Primary Care Network Waiver: Insights into Its Development, Design, and Implementation February 27, 2006 Report This report examines the creation and implementation of Utah’s waiver through interviews with key stakeholders and an analysis of state enrollment data and quarterly reports. Also see Health Affairs article, Can States Stretch the Medicaid Dollar Without Passing the Buck? Lessons from UtahReport (.pdf)
Serving Low-Income Families Through Premium Assistance: A Look At Recent State Activity September 29, 2003 Issue Brief This issue paper examines the policies in the HIFA waiver initiative that provide incentives for states to use Medicaid/SCHIP funds to assist in the purchase of private insurance options. It also reports on how states have responded to these new policies and what key policy questions are raised about premium…
Medicaid Section 1115 Waivers: Current Issues December 30, 2004 Fact Sheet This fact sheet provides a brief introduction to Section 1115 waivers in the Medicaid program and highlights policy issues related to recent waiver activity. Fact Sheet (.pdf)
Coverage Gains Under Recent Section 1115 Waivers: A Data Update July 31, 2005 Issue Brief This brief assesses the extent to which recent Section 1115 waivers have helped reduce the number of uninsured people and finds that there has been a net gain in coverage of 426,329 people under recent waivers.Issue Paper (.pdf)
Tennessee Section 1115 Waiver Amendment Proposal Fact Sheet October 1, 2004 Fact Sheet This new fact sheet summarizes Tennessee’s proposed waiver amendment to its TennCare program, which was submitted to the federal government in September 2004.