Enrollment

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Medicaid Managed Care Enrollment Report

This report profiles enrollment statistics on Medicaid managed care programs on a plan-specific level. It provides national-level summary tables relating to trends, breakout of managed care entities, managed care enrollment by state, regional breakout and states with comprehensive health care reform demonstrations. The information was collected from State Medicaid agencies and CMS Regional Offices.

Short URL: http://www.advancingstates.org/node/53319

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New Medicare-Medicaid Enrollees in Maryland: Demographic and Programmatic Characteristics

This study focuses on new Medicare-Medicaid enrollees in Maryland and the circumstances that shaped their initial eligibility for both programs. This report details the demographic and programmatic characteristics of new enrollees. Specifically, it serves as the vehicle for establishing an initial operational definition of new enrollees and developing the terminology needed to describe the circumstances surrounding initial Medicare-Medicaid eligibility.

Short URL: http://www.advancingstates.org/node/53310

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New Medicare-Medcaid Enrollees in Maryland: Prior Medicare and Medicaid Resource Use

This report describes and analyzes chronic disease patterns and health care expenditures of persons in Maryland who in 2008 began to receive coverage from both Medicare and Medicaid. The analysis focuses on disease and expenditure patterns in the year before these individuals, most of whom had been enrolled in Medicare alone or Medicaid alone, became enrollees in both programs. The results can provide a better understanding of simultaneous enrollment in Medicare and Medicaid.

Short URL: http://www.advancingstates.org/node/53309

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An Overview of Recent Section 1115 Medicaid Demonstration Waiver Activity

Section 1115 waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states significant flexibility in how they operate programs and can have a significant impact on program financing. As such, waivers have important implications for beneficiaries, providers, and states. This brief provides an overview of Section 1115 waiver authority, the waiver approval process, and recent waiver activity and discusses the implications.

Short URL: http://www.advancingstates.org/node/53112

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Medicaid.gov Website

Have you seen the new site sponsored by CMS? This space offers a resource center for states, up to date information about the affordable care act and additional federal policy guidance. The waiver section organizes information by state, program name, waiver authority and status of a application. This chart gives an overview of the four primary types of waivers and demonstration projects: Section 1115, Section 1915(b) Managed Care, Section 1915(c) HCBS, and Concurrent Section 1915(b) and 1915(c).

Short URL: http://www.advancingstates.org/node/53071

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

A growing number of beneficiaries with disabilities are being enrolled in risk-based managed care arrangements. Further growth in managed care is expected in 2014, when the Affordable Care Act expands Medicaid eligibility to many uninsured low-income adults, including those with disabilities. 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.

Short URL: http://www.advancingstates.org/node/53055

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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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