All Articles In 'Medicaid Managed Care'
Medicare Special Needs Plans: MedPAC Recommendations on Future of Special Needs Plans
Special Needs Plans (SNP) are part of the Medicare Advantage program and were created by the Medicare Modernization Act of 2003 (MMA). There are three types of SNPs, each intended to provide coordinated care for Medicare [...]
Medicare and Medicaid Spending on Dual Eligible Populations: Analysis of Health Costs
Much of the story about rising health costs and spending has to do with relatively small groups of people with expensive health needs. For example, the Centers for Medicare and Medicaid Services (CMS) estimates Medicare beneficiaries [...]
Medicaid Expansion Through Health Insurance Marketplaces: Unresolved Questions
The Centers for Medicare and Medicaid Services (CMS) has answered some questions about how Arkansas’s creative plan to expand Medicaid under the Affordable Care Act (ACA). The plan, which Gov. Mike Beebe put forward, would use [...]
Medicaid Prescription Drugs: Utilization in Medicaid Health Plans and Medicaid Fee-for-Service
What’s the impact on patient care, particularly prescription drug utilization, as Medicaid beneficiaries move from fee-for-service to Medicaid health plans? This year, state Medicaid programs will spend over $22.1 billion on pharmacy benefits. This will grow to [...]
Medicaid Expansion Via Health Insurance Exchanges: CMS Answers on Premium Assistance and Waivers
Some states have expressed interest in using premium assistance to expand Medicaid eligibility under the Affordable Care Act (ACA). Instead of serving the new ACA Medicaid expansion population through the Medicaid delivery system (through Medicaid health [...]
Strategic Approach to Qualified Health Plans in Health Insurance Exchanges: Selecting and Managing QHPs
The qualified health plan contracting process in Health Insurance Exchanges present many opportunities and challenges for states and the Centers for Medicare and Medicaid Services (CMS). Success in implementing the Exchanges – one of the Affordable [...]
Medicare-Medicaid Dual Eligibles: Measuring Quality of Special Needs Plans and State Demonstrations
Medicare-Medicaid dual eligibles are often held up as a prime case for the need for better care management to reduce health costs and spending while improving quality. But doing so can be challenging. Most dual eligibles [...]
Electronic Health Records: Best Practices in Washington State Save Medicaid Money
Health information technology, care coordination, and cost containment have increasingly become entwined in health care policy. Medicare and Medicaid both have electronic health record (EHR) incentive programs to encourage physicians, hospitals, and other providers to use [...]
Medicaid Reform: Lessons from Medicaid Payment and Delivery Reforms in Three States
Today, Medicaid spends nearly $500 billion a year on health care for about 71 million Americans. Responsible for a quarter of state budgets, the highly complex program is poised to grow dramatically under the Affordable Care [...]
A Way to Lower Premiums under Arkansas Medicaid Expansion Plan
Policy circles are abuzz with news about Arkansas Governor Mike Beebe’s creative plan to expand Medicaid under the Affordable Care Act. While details are sketchy and there’s no official federal approval yet, the basic idea is [...]
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