Quality Measures

This month’s Kaiser Health Tracking Poll finds public opinion of the Affordable Care Act (ACA) continues to be almost evenly split The poll also asks about health care priorities for the President and Congress, and the concern that comes out on top for Democrats, Republicans and independents alike is making sure that high-cost drugs for chronic conditions are affordable to those who need them. Other than high-cost prescription drugs, Democrats, Republicans and independents have different ideas of their top priorities in health care. The poll also assesses Americans’ use of comparative price and quality information about doctors, hospitals and health plans.

This fact sheet provides a brief overview of quality measures related to long-term services and supports rebalancing.

This issue brief summarizes the key issues related to measuring performance in LTSS rebalancing identified and discussed by participants in an expert roundtable meeting on November 13, 2014.

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.

This issue brief analyzes key themes in 19 capitated § 1115 and § 1915(b)/(c) Medicaid managed long-term services and supports (MLTSS) waivers approved to date by the Centers for Medicare and Medicaid Services (CMS) with a focus on covered populations and services, provisions aimed at expanding beneficiary access to HCBS, beneficiary protections, and quality measurement and oversight.

Today a record three in 10 Medicare beneficiaries are enrolled in Medicare Advantage health plans, mainly HMOs and PPOs, which are paid by the government to provide Medicare benefits to their enrollees. Given the projected rise in Medicare Advantage enrollment, an important question for both consumers and policymakers is how…

As the number of Medicare Advantage enrollees continues to climb, there is growing interest in understanding how the care provided to Medicare beneficiaries in Medicare Advantage plans differs from the care received by beneficiaries in traditional Medicare. This literature review of more than 40 studies synthesizes the evidence to date comparing access and quality for beneficiaries in Medicare Advantage plans and traditional Medicare.

This report discusses key responsibilities that the federal government and states hold for managing the Medicaid program and identifies the key issues and challenges states face as they transform the way they do business and achieve key national goals. The paper relies on an extensive review of federal and state administrative responsibilities drawn from statute, regulation, and relevant literature, coupled with discussions with six current Medicaid directors.

Medicaid now covers more than 1 in every 5 Americans, and millions of uninsured individuals will become newly eligible for Medicaid under the ACA. Considering Medicaid’s large and growing coverage role, an evidence-based assessment of the program’s impact on access to care, health outcomes, and quality of care is of major interest. This brief takes a look at what the research literature shows regarding the difference Medicaid makes.

This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act’s reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.