Medicaid

State Medicaid programs saw a doubling of prescriptions for medications used to treat Opioid Use Disorder (OUD) or rapidly reverse opioid overdoses from 2016 to 2019, finds a new KFF analysis. KFF analysts studied the latest available Medicaid claims data — detailed and comprehensive administrative data that can help answer…

This analysis builds on previous KFF work by using Medicaid claims data for 2016-2019 to explore how prescriptions for opioids used to treat pain and those used to treat OUD or rapidly reverse overdose changed across states and Medicaid enrollee demographic groups over time.

In its role as a public program and the single largest payer of behavioral health services in the country, Medicaid is particularly well positioned to implement policy to improve the delivery, quality, and effectiveness of behavioral health services. Our analysis finds that 7.3 percent of Medicaid enrollees ages 12 to 64 had at least one clinically-identified substance use disorder in 2019, but this is likely an undercount, as other research suggests that prevalence is at least 4 times higher. People with clinically-identified SUD were more likely to be male, White, over 25 years old, and qualify for Medicaid based on a disability or through Medicaid expansion. Rates of clinically-identified SUD vary across states not only because of prevalence, but also because of other factors, such as provider screening behavior and variation in Medicaid coverage of services. National recommendations instruct providers to screen for substance use and conduct brief interventions for adults 18+, yet there may be gaps between SUD screening and referral. Other factors–such as patient privacy concerns or few healthcare visits–may also play a role in low identification of SUD.

Concerns about youth mental health and access to care continues to increase. Schools can be an easy access point for behavioral health services and Medicaid provides significant financing for the delivery of these services in schools. In this analysis, we explore the strategies state Medicaid programs are taking to promote and improve access to school-based behavioral health services, and how recent policies call on Medicaid to expand access to care for youth, particularly in schools.

This brief presents findings from a survey and roundtable discussion of Medicaid managed care plans about the role they may play in the unwinding of the pandemic-era continuous enrollment provision.

On January 26, the Centers for Medicare and Medicaid Services (CMS) approved California’s Section 1115 request to cover a package of reentry services for certain groups of incarcerated individuals 90 days prior to release. This approval is the first to include a partial waiver of the statutory Medicaid inmate exclusion policy, which prohibits Medicaid from paying for services provided during incarceration (except for inpatient services).

This post provides an overview of how health care coverage and access will and won’t change when the public health emergency ends on May 11, including a discussion of COVID-19 vaccines, tests, and treatments, and telemedicine.

The 12.5 million people who are jointly enrolled in Medicare and Medicaid include some of the poorest individuals in the U.S. with some of the highest health needs, requiring disproportionately high spending from both programs to support them. Two new KFF analyses examine the demographics of this population as well…

This brief examines national and state-level data on enrollment and spending for Medicare-Medicaid enrollees using the 2019 and 2020 Medicare Beneficiary Summary Files and the 2019 Transformed Medicaid Statistical Information System (T-MSIS). Spending data for Medicare includes beneficiaries in traditional Medicare only, since spending data for beneficiaries enrolled in Medicare Advantage plans are unavailable. State-level data on Medicare-Medicaid enrollment and spending are available through KFF’s State Health Facts.

This brief examines the demographic, socioeconomic, and health characteristics of Medicare-Medicaid enrollees using the 2020 Medicare Current Beneficiary Survey. It highlights the diversity within the Medicare-Medicaid population and how Medicare-Medicaid enrollees differ from all other Medicare beneficiaries.