Medicare’s Role for Dual Eligible Beneficiaries April 4, 2012 Issue Brief About 9 million low-income seniors and younger people with disabilities in the United States are covered by both Medicare and Medicaid. This brief examines the role of Medicare in providing health coverage for these beneficiaries. Medicare is the primary source of health insurance, while Medicaid provides supplemental coverage, helping with…
An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees April 1, 2012 Issue Brief Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans…
The Diversity of Dual Eligible Beneficiaries: An Examination of Services and Spending for People Eligible for Both Medicaid and Medicare April 1, 2012 Issue Brief This issue brief analyzes linked Medicare and Medicaid data to examine dual eligibles’ utilization and spending in both programs in 2007. As a group, dual eligibles are costly—with per capita Medicare and Medicaid spending over four times Medicare spending for other beneficiaries. However, a small share of dual eligibles account…
Among Dual Eligibles, Identifying The Highest Cost Individuals Could Help In Crafting More Targeted And Effective Responses April 1, 2012 Report This Health Affairs article by researchers at the Urban Institute analyzes linked Medicare and Medicaid data to examine dual eligibles’ utilization and spending in both programs in 2007. It finds that while the population of people dually eligible for Medicare and Medicaid is indeed costly, it is not monolithic. For…
Medicaid and Managed Care: Key Data, Trends, and Issues February 1, 2012 Issue Brief This brief provides a snapshot of the Medicaid program’s use of managed care to deliver services to beneficiaries. It examines the prevalence of managed care in state Medicaid programs; the various approaches states have used, including primary-care case management; managed care for long-term services and for beneficiaries dually eligible for…
Dual Eligibles Tutorial January 10, 2012 Interactive This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to…
Briefing, Survey Examine 2012 Data From 50-State Survey of Medicaid and CHIP Eligibility and Enrollment Policies December 31, 2011 Event Despite continued tight state budgets, a requirement in the Affordable Care Act (ACA) that states maintain eligibility in Medicaid and Children’s Health Insurance Programs was central in preserving coverage during 2011. In addition, more than half of states (29) made improvements in their programs, often using technology to increase program…
Financial Alignment Models for Dual Eligibles: An Update November 1, 2011 Issue Brief The nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design…
States Focus on Cost Containment as a Loss of Federal Stimulus Funds Means State Costs for Medicaid Will Jump in FY 2012 October 27, 2011 News Release NEWS RELEASE Thursday, October 27, 2011 New 50-State Survey Finds Cuts In Provider Payments And Changes In Delivery Of Services WASHINGTON, D.C. – Faced with the end of stimulus money and a continuing weak economy, Medicaid officials in virtually every state are enacting a variety of cost cutting measures as states’…
Medicaid’s Long-Term Care Users: Spending Patterns Across Institutional and Community-based Settings October 1, 2011 Issue Brief The nation’s primary payer for long-term services and supports, Medicaid finances 43 percent of all spending on long-term care services and covers a range of services and supports, including those needed by people to live independently in the community, as well as services provided in institutions. This report provides an…