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The Henry J. Kaiser Family Foundation

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…

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El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!

El seguro de salud, explicado: ¡los YouToons lo tienen cubierto!

En Español El seguro de salud, explicado: ¡los YouToons lo tienen cubierto! desglosa conceptos de seguros como primas, deducibles y redes de proveedores.  Explica cómo las personas pagan por su cobertura y cómo obtener cuidado médico y medicamentos recetados con distintos tipos de seguros de salud, incluyendo HMOs y PPOs.…

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The Henry J. Kaiser Family Foundation

What Drives Spending and Utilization on Medicaid Drug Benefits in States?

With the approval of new specialty drugs, such as the Hepatitis C treatments Sovaldi and Harvoni, states are mindful that the cost the Medicaid prescription drug benefit could increase. To achieve savings, and improve management and health outcomes, it is important to understand which drugs are most frequently prescribed and which drive spending. Using state drug utilization data provided through the Medicaid Drug Rebate Program, as well as an industry drug database, this issue brief examines trends in prescriptions and spending before rebates, and places findings in the context of policy discussion.

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The Henry J. Kaiser Family Foundation

The State Innovation Models (SIM) Program: An Overview

This fact sheet provides an overview of the Center for Medicare and Medicaid Innovation (Innovation Center)’s State Innovation Models (SIM) initiative. It focuses on the delivery system and payment approaches that Model Testing states are taking and discusses what SIM means for Medicaid. Six states – Arkansas, Maine, Massachusetts, Minnesota, Oregon, and Vermont — received Model Testing awards to implement and test their Innovation Plans over 42 months.

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The Henry J. Kaiser Family Foundation

The Uninsured: A Primer – Key Facts About Health Insurance and the Uninsured in America

The Uninsured: A Primer presents basic information about health coverage and the uninsured population leading up to and after the implementation of the Affordable Care Act–who the uninsured are and why they do not have health coverage, and the impact lack of insurance can have on health outcomes and personal finances.

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The Henry J. Kaiser Family Foundation

Peterson-Kaiser Health System Tracker

The Peterson Center on Healthcare and the Kaiser Family Foundation have partnered to monitor how well the U.S. healthcare system is performing in terms of quality and cost. The Peterson-Kaiser Health System Tracker is an online hub providing comprehensive data on how the system is performing on critical quality and cost…

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The Henry J. Kaiser Family Foundation

New Interactive Data Tool Tracks Medicaid Managed Care Market

The Medicaid Managed Care Market Tracker, a new feature of the Foundation’s State Health Facts data center, provides the latest data on key dimensions of risk-based Medicaid managed care for the 39 states that contract with MCOs – these states are home to more than 90 percent of all Medicaid beneficiaries nationwide. On Thursday, December 11 at 12:30 p.m. ET, the Foundation will host an interactive web briefing with Medicaid managed care expert Julia Paradise, an Associate Director of the Foundation’s Kaiser Commission on Medicaid and the Uninsured.

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The Henry J. Kaiser Family Foundation

Key Findings on Medicaid Managed Care: Highlights from the Medicaid Managed Care Market Tracker

This report highlights 10 key findings on the Medicaid managed care market, based on analysis of data included in the Kaiser Family Foundation’s Medicaid Managed Care Market Tracker. The findings provide a partial profile of the Medicaid MCO market nationally and by state. They also illuminate the involvement of large, multi-state health insurance companies in the Medicaid market and the participation of these firms in other markets as well, including the managed long-term services and supports market, the new ACA marketplaces, and the Medicare Advantage market. Finally, these selected highlights serve to illustrate the array of ways the Tracker can be used to understand more about the Medicaid managed care market and its place in the broader market.

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YouToons: Health Insurance Explained

Health Insurance Explained: The YouToons Have it Covered

In this five-minute animated video, the YouToons help consumers understand their health insurance through fun, easy-to-understand explanations and scenarios. This cartoon serves as a tutorial for consumers and organizations. The YouToons previously appeared in the 2010 animated movie, “Health Reform Hits Main Street” and the 2013, “The YouToons Get Ready for Obamacare: Health Insurance Changes Coming Your Way Under the Affordable Care Act.”

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The Henry J. Kaiser Family Foundation

Estimating Federal Payments and Eligibility for Basic Health Programs: An Illustrative Example

In some states, policymakers and stakeholders are considering adoption of the Basic Health Program (BHP) option permitted under the Patient Protection and Affordable Care Act (ACA). Federal regulations allow BHP implementation beginning in 2015. Through BHP, consumers with incomes at or below 200 percent of the federal poverty level (FPL) who would otherwise qualify for subsidized qualified health plans (QHPs) offered in health insurance marketplaces instead are offered state-contracting standard health plans that provide coverage no less generous and affordable than what have been provided in the marketplace. To operate BHPs, states receive federal funding equal to 95 percent of the premium tax credits (PTCs) and cost-sharing reductions (CSRs) that BHP enrollees would have received if they had been covered through QHPs. This paper seeks to inform state-level analysts about the characteristics of BHP-eligible people in their state and how to use that information to estimate the approximate federal BHP payment amount per average BHP-eligible resident.

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