Medicaid

States Lag in Reducing Nursing Home Utilization

States are not making adequate progress toward keeping seniors and the disabled out of nursing homes by making greater use of home and community-based services. Or so concludes a new study from AARP. According to the study, only nine states and Washington, D.C. spend more on home and community-based services and long-term services and supports than on nursing homes. Minnesota leads the nation, spending 69 percent of its long-term-care money on home and community-based services. Other leaders include Washington state (65 percent), New Mexico (64 percent), and Alaska (63 percent). Alabama pulls up the rear with only 14 percent. The [...]

The Prospect of a Medicaid Work Requirement

Over the past three years a dozen states have proposed establishing a work requirement for eligibility for their Medicaid programs and in its proposed FY 2018, the Trump administration has called for extending the ability to impose such a requirement to all states. But how would a Medicaid work requirement work? To whom would it apply and what kinds of work might satisfy such a requirement for the approximately 22 million Medicaid recipients (out of 76 million total recipients) to whom it might apply? A new Commonwealth Fund report looks at these and other issues. Go here to find the [...]

iqtsupport2017-05-31T16:28:01-04:00May 31, 2017|Medicaid, Medicaid regulations|

States Get More Time to Improve Approach to Serving the Elderly, Disabled

The federal government is giving state three additional years to improve their Medicaid-funded efforts to help keep the elderly and the disabled in the community. The requirement, established in 2014 for implementation by 2019, requires states to do more to enable the elderly to remain in their homes rather than go to nursing homes and to help the disabled live and work in the community or at least have greater control of their own lives while residing in group home settings. Among the approaches states have been developing in response to the federal requirements are offering seniors programs of long-term [...]

iqtsupport2017-05-16T06:00:49-04:00May 16, 2017|Medicaid, Medicaid and housing for the disabled, Medicaid regulations|

MACPAC Meets

Last week the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. The agency performs policy and data analysis and offers recommendations to Congress, the Department of Health and Human Services, and the states. During two days of meetings, MACPAC commissioners received the following presentations: Federal CHIP Funding Update: When Will States Exhaust Their Allotments? Review of June Report Chapter: Program Integrity in Medicaid Managed Care Review of June Report Chapter: Medicaid and the Opioid Epidemic Medicare Savings Program: Eligible But Not Enrolled Medicaid Reform: Implications of Proposed Legislation Preliminary Findings From Evaluations of Medicaid Expansions Under Section [...]

iqtsupport2017-05-04T06:00:23-04:00May 4, 2017|Medicaid|

Health Reform Helps Hospitals in Medicaid Expansion States

The Affordable Care Act’s enhancement of access to health insurance, whether through Medicaid expansion or the subsidization of insurance premiums for working-class and some middle-class Americans, has improved the financial health of hospitals. Especially hospitals in Medicaid expansion states. According to a new report from the Urban Institute, Using data through fiscal year 2015, this new analysis finds that the Medicaid expansion under the ACA increased Medicaid revenue by $5.0 million per hospital, reduced costs of uncompensated care by $3.2 million per hospital, and improved average operating margins by 2.5 percentage points. This study also finds that the financial benefits [...]

iqtsupport2017-04-24T06:00:07-04:00April 24, 2017|Affordable Care Act, hospitals, Medicaid|

Medicaid Work Requirements

Both Congress and a number of states have discussed introducing work requirements into their Medicaid programs. Such a proposal was part of the American Health Care Act, a number of governors and state legislators have discussed work requirements as a condition of Medicaid eligibility, and some states are reportedly considering including such requirements in section 1115 Medicaid waiver applications. In a new report, the Congressional Research Service examines the U.S. Department of Health and Human Services’ authority to grant such waivers and how courts might look at such requirements if they were be contested. Go here to see the Congressional [...]

iqtsupport2017-04-21T06:00:59-04:00April 21, 2017|Medicaid|

Medicaid Per Capita Caps Explained

In a new report, the Commonwealth Fund looks at Medicaid per capita caps, an idea that has been discussed for years, that was part of the as-yet unsuccessful American Health Care Act, and a proposal that is almost certain to resurface in the near future. Among other things, the article explains what per capita caps are and how they would work describes how per capita caps differ from current Medicaid policy considers how the implementation of per capita caps might affect low-income people, providers, and insurers Learn more in the Commonwealth Fund article “Essential Facts About Health Reform Alternatives: Medicaid [...]

iqtsupport2017-04-19T06:00:53-04:00April 19, 2017|Medicaid|

New MACPAC Study Evaluates Medicaid, Medicare Payments

Medicaid payments to hospitals are comparable to or even higher than Medicare payments. Or at least they are once supplemental Medicaid payments are included. So concludes a new study by the Medicaid and CHIP Payment and Access Commission, a non-partisan legislative branch agency that advises the states, Congress, and the administration on Medicaid and CHIP payment and access issues. In what MACPAC bills as the “first-ever study to construct a state-level payment index to compare fee-for-service inpatient hospital payments across states and to benchmark Medicaid payments to other payers such as Medicare,” the study found that Across states, base Medicaid [...]

iqtsupport2017-04-17T06:00:40-04:00April 17, 2017|MACPAC, Medicaid, Medicare|

To Require Work or Not to Require Work

That is the question policy-makers are asking as they consider imposing work requirements on healthy Medicaid participants. In recent years a number of states have attempted to establish such a requirement, only to have their requests to do so rejected by regulators in Washington, and a clause permitting states to establish such a requirement was included last month in the eventually sidetracked American Health Care Act. Even now, a Kentucky Medicaid waiver application under consideration by the Centers for Medicare & Medicaid Services includes a work requirement. Does the lack of a work requirement encourage people in Medicaid expansion states [...]

iqtsupport2017-04-03T06:00:50-04:00April 3, 2017|Medicaid|

CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts

In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.” How is that initiative working so far? CMS recently released three reports that evaluate different aspects of the program. Those reports are: “Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative” “Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative” “Issue Brief: Special Populations Enrolled in Demonstrations under the Financial [...]

iqtsupport2017-03-29T06:00:30-04:00March 29, 2017|Centers for Medicare & Medicaid Services, Medicaid, Medicare|