A Focus Group with Medicaid Directors: As FY 2012 Ends, Looking Toward FY 2013 June 1, 2012 Report This report is based on a focus group discussion in May 2012 with the Executive Board of the National Association of Medicaid Directors (NAMD) and other leading Medicaid directors. The group of nine directors reflected perspectives from various regions of the country. The discussion focused on state fiscal conditions, Medicaid…
Prescription Drug Procurement and the Federal Budget May 8, 2012 Issue Brief This brief commissioned by the Foundation considers areas where Medicare faces limited opportunity for market-based competition and price negotiation to drive down drug spending. These areas include drug purchasing for low-income people enrolled in Part D plans who face minimal cost-sharing requirements, and purchasing certain unique drugs, such as biologicals,…
Behavioral Health: Can Primary Care Help Meet the Growing Need? May 4, 2012 Event The health reform law has specific provisions covering mental health and substance use conditions, as well as general provisions to benefit those in need of behavioral health services. While addressing unmet needs, the reform law provisions raise new challenges. Given their budgetary constraints, will states be able to expand capacity…
Massachusetts Health Care Reform: Six Years Later May 1, 2012 Issue Brief In 2006, then-Gov. Mitt Romney signed Massachusetts’ comprehensive health reform designed to provide near-universal health insurance coverage for state residents. Building on a long history of health reform efforts, the state embarked on an ambitious plan to promote shared individual, employer, and government responsibility. This brief examines Massachusetts’ experience with…
Federal Funding Under the Affordable Care Act April 12, 2012 Fact Sheet This fact sheet provides highlights from an analysis tracking the flow of federal Affordable Care Act funds to states as reporter in the Department of Health and Human Services grant database as well as periodic reports from HHS and the Internal Revenue Service. The analysis distinguishes between funds awarded to…
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…
How Does the Benefit Value of Medicare Compare to the Benefit Value of Typical Large Employer Plans?: A 2012 Update April 4, 2012 Issue Brief This study compares the value of Medicare’s fee-for-service benefits last year with the value of benefits in two large employer health plans — a large health plan serving federal employees and a typical large employer Preferred Provider Organization (PPO) plan. For individuals ages 65 and older, the study finds that…
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…
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…
Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors March 3, 2012 Issue Brief As part of broad deficit-reduction plans, policymakers are considering reforms to the nation’s three major entitlement programs – Medicare, Medicaid and Social Security – that could significantly affect the economic security of seniors in their retirement years. This brief examines the role of these programs in ensuring seniors’ financial security…