All Articles In 'Medicaid'

Integrating Care for Medicare-Medicaid Dual Eligibles: A Primer for States

Integrating Care for Medicare-Medicaid Dual Eligibles: A Primer for States

Improving care integration for Medicare-Medicaid dual eligible beneficiaries is one of the many initiatives embedded in the Affordable Care Act (ACA). The health reform law created the Medicare-Medicaid Coordination Office at the Centers for Medicare and [...]

Dual Eligibles and Long Term Care: Nursing Home Care Often Costs Less Than Home or Community Care

Dual Eligibles and Long Term Care: Nursing Home Care Often Costs Less Than Home or Community Care

Medicare-Medicaid dual eligibles are often talked about as a single type of patient. They have significant levels of disability and chronic disease, and account for a disproportionately large spending in both Medicare and Medicaid budgets. But [...]

Health Insurance Costs and the ACA: New Study Estimates Premiums and Enrollment

Health Insurance Costs and the ACA: New Study Estimates Premiums and Enrollment

Debate about whether consumers will pay more for insurance under health reform has become political, with conservative organizations saying Obamacare will increase premiums and liberals saying it won’t, at least not when you take into account [...]

Risk Adjustment for Health Plans Under ACA: Evaluating, Improving Risk Adjustment Models

Risk Adjustment for Health Plans Under ACA: Evaluating, Improving Risk Adjustment Models

Risk adjustment is a key mechanism to ensuring appropriate payments for Medicare Advantage plans, Medicare Part D drug plans, and Medicaid health plans.  Since health plans vary in their mix of healthy and sick enrollees, risk adjustment [...]

Hospital Costs: Handful of Conditions Account for Half of Hospital Costs

Hospital Costs: Handful of Conditions Account for Half of Hospital Costs

Hospital costs are of keen interest to Medicare, Medicaid, and private health insurers these days, who pay the vast majority of hospital costs. Which services are the most expensive? Which types of health coverage are responsible [...]

Smoking Cessation Coverage for Pregnant Women in Medicaid and Health Insurance Exchanges

Smoking Cessation Coverage for Pregnant Women in Medicaid and Health Insurance Exchanges

The Affordable Care Act (ACA) coverage expansions to childless adults, through Medicaid and Health Insurance Exchanges, could have broad effects on public health. A recent study gives us one good example of that by showing that [...]

Geographic Variation in Health Care Spending and Medicare Payment Reform

Geographic Variation in Health Care Spending and Medicare Payment Reform

In the ongoing struggle over wasteful health care spending, geographic cost variation is a veteran hot topic. The fact that public programs and private health plans spend more for providers in some regions, even after accounting [...]

Medicaid Accountable Care Organizations: Provider Capabilities and State Supports

Medicaid Accountable Care Organizations: Provider Capabilities and State Supports

Though most commonly associated with Medicare, Accountable Care Organizations are now making their way into state Medicaid programs. Providers, of course, are an essential part of the ACO model. But many providers don’t yet have the [...]

Shared Savings: Most Popular Model, Best Practices for Accountable Care Organizations

Shared Savings: Most Popular Model, Best Practices for Accountable Care Organizations

Even as Accountable Care Organizations and other payment reform models become more common, there is still not much comprehensive information about which models providers participate in most often, and what exactly to do to make those [...]

Former Texas Medicaid Director’s Insights into Payment Reform

Former Texas Medicaid Director’s Insights into Payment Reform

Billy Millwee, former Texas Medicaid director, recently published an excellent piece with insight into that state’s experience with quality-based payment reform. Health care payors, both private and public, are looking more and more to tie payment [...]