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People with Disabilities and Medicaid Managed Care: Key Issues to Consider

This issue brief looks at issues related to the development and implementation of managed care programs with the capacity to serve Medicaid beneficiaries with disabilities. Drawing on existing research on Medicaid managed care and people with disabilities, the brief highlights policy considerations related to setting plan payment rates, developing adequate provider networks and delivery systems, and ensuring sufficient beneficiary protections and plan oversight.

Short URL: http://www.advancingstates.org/node/53050

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Designing Consumer-Friendly Beneficiary Assignment and Notification Processes for Accountable Care Organizations

Families USA released their latest brief that helps advocates understand the basics of Accountable Care Organizations (ACOs) and their potential for improving patient care. The brief includes the basics, payment and quality measurements, determining shared savings and losses, and beneficiary assignment and notification processes.

Short URL: http://www.advancingstates.org/node/53047

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The Center for Medicare and Medicaid Innovation: Activity on Many Fronts

In its first year of operation, the Center for Medicare and Medicaid Innovation has a long list of accomplishments, yet some observers express concern that its fast-paced approach may be overwhelming to smaller delivery systems. A status report of the Innovation Center’s activities to date is provided, including delineating the goals envisioned by Congress, detailing the new tools it was given, and emphasizing how the enhanced authority compares with CMS’ traditional demonstration programs.

Short URL: http://www.advancingstates.org/node/53043

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Building a Relationship between Medicaid, the Exchange and the Individual Insurance Market

Overview provided about individuals and families who can be expected to receive assistance under insurance affordability programs, which include Medicaid, CHIP, advance premium tax credits and cost-sharing reductions, and Basic Health Programs. Particular focus is placed on the characteristics of individuals whose incomes place them at or near the Medicaid/exchange dividing line. The authors identify opportunities for greater collaboration and alignment in key areas.

Short URL: http://www.advancingstates.org/node/53042

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On the Verge: The Transformation of Long Term Services and Supports

Many states are undergoing long-term services & supports (LTSS) transformations. The lagging economy & increased demand for publicly funded LTSS are placing pressure on state policymakers to find solutions. As a result, many states either have or plan to implement Medicaid Managed LTSS, with 12 states having existing programs & another 11 with plans for implementation. Many states used the economic downturn as an opportunity to balance services from institutional to non-institutional settings.

Short URL: http://www.advancingstates.org/node/53034

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NCOA's National Center for Benefits Outreach and Enrollment Website

Organizations are assisted in enrolling seniors & younger adults with disabilities with limited means into the benefits programs for which they are eligible so that they can remain healthy & improve the quality of their lives. New features available on the site include fact sheets with detailed info about core benefits programs, a clearinghouse of promising practices, & a library of sample benefits outreach materials, webinar slides, & publications—all searchable by topic, state, & keyword.

Short URL: http://www.advancingstates.org/node/53033

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Performing Under Pressure: Annual Findings of a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP, 2011-2012

Despite continued fiscal pressures on states, eligibility policies remained stable in nearly all state Medicaid and Children's Health Insurance Programs during 2011. Moreover, many states used technology to increase program efficiency and streamline enrollment. The "maintenance of eligibility" requirement in the Affordable Care Act (ACA) played a key role in preserving coverage levels. Without it, more states likely would have limited eligibility or tightened enrollment procedures.

Short URL: http://www.advancingstates.org/node/53032

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Money Follows the Person Demonstration: Overview of State Grantee Progress, January to June 2011

Enrollment in MFP continued to grow steadily with 15,818 cumulative transitions to the community as of June 30, 2011, a 33 percent increase from the end of 2010. The states reported 3,722 new transitions during the six-month period from January to June 2011, 9 percent more than in the previous six-month period. The report provides an overview of state MFP grantee progress on key performance indicators and challenges states reported when implementing their transition programs.

Short URL: http://www.advancingstates.org/node/53029

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Case Study: Georgia's Money Follows the Person Demonstration

This brief describes key features of Georgia’s MFP program & highlights recent experiences. Through MFP, Georgia has achieved a 2 percent growth in annual spending on home & community-based services. With the extension of MFP under the ACA, the state plans to continue the program through 2016 with hopes to transition more than 2,000 individuals with the help of over $93 million in enhanced federal matching funds. Also, review brief profiles on several Georgia residents enrolled in the program.

Short URL: http://www.advancingstates.org/node/53023

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The Financial Alignment Models for Dual Eligibles: An Update

This policy brief provides information on Washington, DC and the 37 states that are planning to better integrate care for participants who are dually eligible for Medicare and Medicaid. The Center for Medicaid and Medicare Services (CMS) will allow states to select a capitated model, or a managed fee-for-service model, or they can use both models. Included is a chart explaining the main differences between the two models.

Short URL: http://www.advancingstates.org/node/53020


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