Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries September 30, 2012 Issue Brief This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries…
State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS September 30, 2012 Report The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of…
The Affordable Care Act, the Supreme Court, and HIV: What Are the Implications? September 24, 2012 Report This brief explores key provisions of the Affordable Care Act (ACA) for people with HIV, and the opportunities and challenges for using the law to improve HIV care, particularly in light of the Supreme Court’s 2012 ruling on the law.
Current and Emerging Issues in Medicaid Risk-Based Managed Care: Insights from an Expert Roundtable September 1, 2012 Issue Brief Half of all Medicaid enrollees receive care through comprehensive risk-based managed care organizations (MCOs). Most Medicaid MCO enrollees today are low-income children and parents, but states are increasingly moving beneficiaries with more complex needs into MCOs. Managed care enrollment may grow more rapidly as states work with the Centers for…
Health Homes for Medicaid Beneficiaries with Chronic Conditions August 1, 2012 Issue Brief This brief profiles four states that were the first to receive federal approval to take up a state option under the Affordable Care Act to implement health homes for Medicaid beneficiaries with chronic conditions. Almost half of the 9 million people who qualify for Medicaid on the basis of disability…
Comparison of Medicare Premium Support Proposals July 26, 2012 Issue Brief This brief provides a side-by-side comparison of recent proposals to transform Medicare into a premium support program and slow the future growth in Medicare spending. These proposals each would convert Medicare from a defined benefit program, in which beneficiaries are guaranteed coverage for a fixed set of benefits, to a…
Program Integrity in Medicaid: A Primer July 1, 2012 Issue Brief Medicaid covers more than 60 million Americans and accounts for about one in six dollars spent on health care in the United States. Multiple agencies at the state and federal levels are involved in efforts to prevent waste, fraud and abuse in the program and ensure appropriate use of taxpayer…
Chronic Disease Prevention: Saving Lives, Saving Money June 13, 2012 Event The Alliance for Health Reform and the Robert Wood Johnson Foundation sponsored a July 13 luncheon briefing to discuss whether or not public health investments can help prevent chronic disease and reduce escalating health care costs. For more information, please visit the Alliance’s event page. Full version: Video Speakers…
The High and Rising Costs Of Health Care: What Can Be Done? June 12, 2012 Event The Alliance for Health Reform, the Kaiser Family Foundation, and several cosponsors held the final event in a three-part series of discussions on costs, the factors driving them up and what (if anything) can be done about them. This briefing and others in the series take an in-depth look at…
The Health of Safety-Net Hospitals: How are They Faring? What’s the Outlook? June 4, 2012 Event The Alliance for Health Reform and The Commonwealth Fund discusses the critical role of safety-net hospitals in providing care to vulnerable populations. Panelists will explore such questions as: Who does the safety-net system currently serve and how will this patient mix change as the health reform law plays out? How…