Medicaid managed care

Results of Annual Survey of State Medicaid Programs

The Kaiser Family Foundation has published the results of its annual survey of state Medicaid programs for the 2022 and 2023 fiscal years. Among the survey’s findings (in language taken directly from the Kaiser report): More than 3/4 of states that contract with MCOs [managed care organizations] enroll ≥75% of all beneficiaries in MCOs Some states reported newly implementing or expanding MCO programs States also report continued use of other service delivery and payment system reforms Two-thirds of states are using strategies to improve race, ethnicity, and language data About one-quarter of states are tying MCO financial incentives to health [...]

iqtsupport2022-10-27T06:00:07-04:00October 27, 2022|COVID-19, Medicaid, Medicaid long-term services and supports, Medicaid managed care, social determinants of health, Telehealth|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. Supporting the discussion were the following briefing papers: Background on Medicaid Race and Ethnicity Data Collection and Reporting State Strategies and Stakeholder Engagement for Unwinding the Public Health Emergency Continuous Coverage Requirement Improving Rate Setting and Risk Mitigation in Medicaid Managed Care Principles for Assessing Medicaid Nursing Facility Payments Relative to Costs Countercyclical Disproportionate Share Hospital Policies Medicaid Coverage of Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease Review of Proposed Rule on Core Set Reporting and Congressional Request for [...]

iqtsupport2022-09-23T06:00:12-04:00September 23, 2022|MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid long-term services and supports, Medicaid managed care|

Federal Health Policy Update for Wednesday, July 27

The following is the latest health policy news from the federal government as of 2:30 p.m. on Wednesday, July 27. Some of the language used below is taken directly from government documents. Final Medicare Payment Regulations for FY 2023 CMS has issued its final FY 2023 Medicare inpatient rehabilitation facility (IRF) payment system regulation, finalizing a rate increase of 3.9 percent, which is greater than the 2.8 percent the agency proposed in April. To learn more about CMS’s final IRF payment rule for FY 2023, see this CMS fact sheet and the final rule itself. CMS also has finalized its [...]

iqtsupport2022-07-27T17:34:40-04:00July 27, 2022|Centers for Medicare & Medicaid Services, Congress, COVID-19, Medicaid, Medicaid long-term services and supports, Medicaid managed care, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, post-acute care, Telehealth|

Federal Health Policy Update for Thursday, July 7

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, July 7. Some of the language used below is taken directly from government documents. The Courts Hospitals may sue state Medicaid programs for failing to ensure that private insurers – such as Medicaid managed care plans – pay hospitals in a timely manner for the care they provide to their Medicaid patients, a federal appeals court has ruled. See the court’s decision in this case. Centers for Medicare & Medicaid Services CMS has proposed a series of changes in the Medicare cost [...]

iqtsupport2022-07-07T16:56:58-04:00July 7, 2022|Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, Medicaid, Medicaid managed care, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for Thursday, June 30

The following is the latest health policy news from the federal government as of 2:45 p.m. on Thursday, June 30. Some of the language used below is taken directly from government documents. White House The White House has unveiled its “White House Blueprint for Addressing the Maternal Health Crisis.” Monkeypox Update The White House has announced the first phase of its national monkeypox vaccine strategy, a part of its monkeypox outbreak response. The major components of the strategy include expanded efforts to vaccinate those most at risk, expanded testing supply and availability, and greater engagement with community leaders and stakeholders. [...]

iqtsupport2022-06-30T17:01:01-04:00June 30, 2022|Centers for Medicare & Medicaid Services, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations for long-term care, Medicare, Medicare post-acute care, Medicare regulations, MedPAC|

Relatively Few Docs Treating Medicaid Patients

Just a small portion of the providers theoretically available to serve individuals enrolled in Medicaid managed care plans are actually caring for such patients, a new study has found. According to a report in Health Affairs, 25 percent of the primary care physicians serving patients in selected managed care plans are providing 86 percent of the primary care to those plans’ members while 16 percent of those plans’ listed primary care providers have gone more than a year without filing a single claim. Similarly, 25 percent of the medical specialists participating in the plans provided 75 percent of the plans’ [...]

iqtsupport2022-05-10T06:00:21-04:00May 10, 2022|Medicaid, Medicaid managed care|

Federal Health Policy Update for Thursday, April 28

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, April 28. Some of the language used below is taken directly from government documents. White House The White House has announced a series of steps designed to increase the availability of oral treatments for COVID-19. Those steps include nearly doubling the number of places oral antivirals are available in the coming weeks; launching a new effort to establish federally-supported test-to-treat sites; supporting medical providers with more guidance and tools to understand and prescribe treatments; and communicating to the public that safe, effective [...]

iqtsupport2022-04-28T17:23:03-04:00April 28, 2022|Centers for Medicare & Medicaid Services, COVID-19, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C. The following is MACPAC’s own summary of the sessions. During the April 2022 Medicaid and CHIP Payment and Access Commission meeting, the Commission voted to approve a package of recommendations to: create a new approach for monitoring access to care for Medicaid beneficiaries; improve vaccine access for adult Medicaid beneficiaries; improve the oversight and transparency of directed payments in Medicaid managed care; and encourage the adoption of health information technology (IT) in behavioral health. The recommendations will appear in MACPAC’s June report to [...]

iqtsupport2022-04-13T06:00:07-04:00April 13, 2022|Alternative payment models, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations|

Medicaid as a Tool for Addressing Racial Health Inequities

Medicaid can be an important tool for addressing racial health inequities, the Kaiser Family Foundation suggests in a new issue brief. Among the measures involving Medicaid that might be undertaken to address racial health inequities and addressing social determinants of health, the brief suggests (in words taken directly from the issue brief): One significant action that would help close coverage disparities for people of color is adoption of the ACA Medicaid expansion in the 12 non-expansion states. Other expansions of Medicaid eligibility could also address racial disparities in coverage and access to care. Making it easier for eligible people to [...]

iqtsupport2022-03-25T06:00:31-04:00March 25, 2022|Affordable Care Act, Centers for Medicare & Medicaid Services, Congress, COVID-19, health equity, Medicaid, Medicaid managed care, Medicaid regulations|

Federal Health Policy Update for Thursday, March 10

The following is the latest health policy news from the federal government as of 2:30 p.m. on Thursday, March 10. Some of the language used below is taken directly from government documents. White House The White House has posted a transcript of the March 2 press briefing given by its COVID-19 response team to outline the administration’s National COVID-19 Preparedness Plan. 340B Eligibility Protection and Telehealth Extensions in the Omnibus Spending Bill Providers that feared they might lose their eligibility to continue participating in the 340B prescription drug discount program because they have fallen below that program’s Medicare disproportionate share [...]

iqtsupport2022-03-10T17:37:25-05:00March 10, 2022|Centers for Medicare & Medicaid Services, Congress, Coronavirus, COVID-19, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy, MedPAC, Telehealth|