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|

Temporarily Gone But Not Forgotten

While last week’s withdrawal of the American Health Care Act at least temporarily halted talk of immediate repeal and replacement of the Affordable Care Act, at least one aspect of that proposed legislation, often discussed in the past, is sure to arise in the future as well: replacing the current manner in which the federal government matches state Medicaid funding with Medicaid per capita limits or Medicaid block grants. In a new issue brief, the Kaiser Family Foundation examines how a switch to per capita limits or block grants might affect low-income seniors served by both Medicare and Medicaid. Among [...]

iqtsupport2017-03-29T06:00:07-04:00March 29, 2017|Medicaid, Medicare|

MACPAC Looks at Medicaid DSH

Hospitals that serve especially large numbers of Medicaid and low-income patients still need Medicaid disproportionate share hospital payments (Medicaid DSH) to avoid red ink despite the expansion of Medicaid and the increase in the number of uninsured people fostered by the Affordable Care Act. So concludes the Medicaid and CHIP Payment and Access Commission (MACPAC) the non-partisan legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program issues. In its March 2017 report to Congress, MACPAC writes that In both expansion and non-expansion [...]

iqtsupport2017-03-23T06:00:53-04:00March 23, 2017|Affordable Care Act, hospitals, Medicaid|

MACPAC Looks at High-Cost Hepatitis C Drugs

The emergence of exceptionally high-cost drugs that offer unprecedented benefits for Hepatitis C patients has posed a considerable challenge to state Medicaid programs: the drugs offer cures, not treatment, yet their costs are potentially budget-busting. The Medicaid and CHIP Payment and Access Commission commissioned a study to evaluate how these new drugs and their cost have affected state Medicaid programs and the managed care organizations that serve most Medicaid beneficiaries. Among the issues the study considered were: state coverage and prior authorization policies the impact of the new drugs on state Medicaid budgets and Medicaid managed care organizations how these [...]

iqtsupport2017-03-10T06:00:07-05:00March 10, 2017|Medicaid|

MACPAC Meets, Discusses Medicaid, CHIP Issues

The non-partisan legislative branch agency that advises Congress, the Secretary of Health and Human Services, and the states on a variety of Medicaid and State Children’s Health Insurance Program issues met last week in Washington, D.C. Among the issues on the agenda of the Medicaid and CHIP Payment and Access Commission were: the flexibility of states in structuring and administering their Medicaid and CHIP programs state Medicaid responses to fiscal pressures studies requested by Congress on mandatory/optional benefits and populations current Medicaid parallels to per capita financing options illustrations of state-level effects of per capita cap design elements high-cost hepatitis [...]

iqtsupport2017-03-08T11:26:27-05:00March 8, 2017|Medicaid|

Changing Medicaid

With policy-makers in Washington considering some changes, and possibly major changes, in the state/federal Medicaid partnership, the Health Affairs Blog has taken a look at some of the options those policy-makers might consider. Among them are: giving states greater flexibility in the design and implementation of their own Medicaid programs requiring cost-sharing by some or all beneficiaries, such as through premiums and co-payments limiting benefits employing incentives to encourage healthy behaviors The article also considers the manner in which individuals enroll in Medicaid and how that has evolved over the years. Learn more about some of the options Congress will [...]

iqtsupport2017-02-17T06:00:54-05:00February 17, 2017|Medicaid|

Medicaid Directors Look at Value-Based Purchasing

One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing. In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing: what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts. For a closer look at Medicaid value-based purchasing, [...]

iqtsupport2017-02-15T13:00:30-05:00February 15, 2017|Medicaid|