Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California July 1, 2013 Issue Brief This brief examines how health service providers, plan administrators, and community-based organizations in Contra Costa, Kern, and Los Angeles Counties experienced the transition of Medi-Cal-only seniors and persons with disabilities (SPDs) to managed care as part of the state’s “Bridge to Reform” Medicaid waiver. Findings presented may inform similar transitions of high-need beneficiaries in other states and coverage expansions in 2014 under the Affordable Care Act.
Improving the Financial Accountability of Nursing Facilities June 28, 2013 Report This report examines nursing facility expenditures to assess relative spending increases in areas such as nursing services, administrative costs, and profits. Using California as a case study, it explores reimbursement by cost category and a standard medical loss ratio (MLR) as potential policy options to improve nursing facility financial accountability and care quality.
Medicaid Managed Care in the Era of Health Reform – Briefing and Panel Discussion June 25, 2013 Event Amid increasing state and national interest in using managed care delivery models for Medicaid beneficiaries, the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) hosted a public briefing on Tuesday, June 25, 2013 to provide information on recent transitions from fee-for-service to managed care, and to discuss their…
California’s Health Care Environment and Health Reform Efforts: June 2013 Update June 25, 2013 Issue Brief This brief provides and update of the health care and health policy environment in California, discussing the budgetary environment, implementation of the state’s “Bridge to Reform” Medicaid waiver, and efforts to prepare for coverage expansions and new coverage options in 2014 under the Affordable Care Act.
Quality of Care in Community Health Centers and Factors Associated with Performance June 10, 2013 Issue Brief 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.
Key Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act June 4, 2013 Issue Brief The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces. However, effective outreach and enrollment efforts will be key to ensuring that new coverage opportunities translate into increased coverage. Based on a review of existing research,…
Profiles of Medicaid Outreach and Enrollment Strategies: Helping Families Maintain Coverage in Michigan May 14, 2013 Issue Brief This brief provides insight into lessons learned from Medicaid and CHIP outreach and enrollment strategies by profiling a successful initiative of the Michigan Primary Care Association to facilitate coverage renewals through a systematic, technology-based reminder system coupled with one-on-one assistance. The brief is part of the “Getting Into Gear for…
Stop the Drop: Profiles of Innovative Medicaid Renewal Initiatives and Lessons for 2014 and Beyond May 14, 2013 Event Under the Affordable Care Act (ACA), there will be a new continuum of coverage options available beginning in 2014. While there currently is significant focus on enrolling eligible people into these new coverage options, it also is important to plan for how to keep eligible people enrolled in coverage over…
Financing Medicaid Coverage Under Health Reform: What is in the Law and the New FMAP Rules May 9, 2013 Issue Brief This brief examines the ACA law and new regulations related to the match rates for coverage under the ACA for Medicaid and Children’s Health Insurance Program.
What Difference Does Medicaid Make? Assessing Cost Effectiveness, Access, and Financial Protection under Medicaid for Low-Income Adults May 3, 2013 Issue Brief This brief examines the cost and use of health care among low-income nonelderly adults who are covered by Medicaid relative to their expected service use and costs if they instead had employer-sponsored insurance (ESI) coverage or were uninsured. The analysis controls for a wide array of factors that also influence utilization and spending in an effort to isolate the specific effects of Medicaid coverage. Consistent with previous research, the analysis underscores how Medicaid facilitates access to care for program beneficiaries.