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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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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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Home and Community-Based Service Waivers, Total Number of Medicaid 1915(c) in 2008

The latest HCBS data from The Kaiser Commission on Medicaid and the Uninsured and the University of California at San Francisco analysis of The Centers for Medicare & Medicaid Services (CMS) Form 372 have been added and are available for all states and the nation for 2008. This website allows you to do an interactive search. Review the updated topics including total HCBS waivers, participants by waiver type, home health expenditures, and personal care participants.

Short URL: http://www.advancingstates.org/node/53026

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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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Medicaid Home and Community-Based Services Programs: Data Update December 2011

Developing home & community-based service (HCBS) alternatives to institutional care has been a priority for many state Medicaid programs over the last three decades. While the majority of Medicaid long-term care dollars still go toward institutional care, the national percentage of Medicaid spending on HCBS has more than doubled from 19% in 1995 to 43% in 2008. More than 3 million people were served by Medicaid HCBS programs in 2008 and hundreds of thousands of people are on waiting lists.

Short URL: http://www.advancingstates.org/node/53019

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Moving Ahead Amid Fiscal Challenges: A Look at Medicaid Spending, Coverage and Policy Trends Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2011 and 2012

Medicaid officials in every state are enacting a variety of cost cutting measures as states’ spending is projected to increase 28.7% in FY2012 to make up for the loss of federal stimulus money. The survey finds cost containment actions ranging from restrictions on payments to providers & benefits, to new copayments for beneficiaries & additional efforts to contain the costs of prescription drugs. States are also trying to make their programs more efficient through a number of procedures.

Short URL: http://www.advancingstates.org/node/52996

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A Profile of Medicaid Managed Care Programs in 2010: Findings from a 50-State Survey

Most Medicaid beneficiaries are enrolled in some form of managed care. States are expected to increase their reliance on managed care to deliver services in their Medicaid programs. This 50-state survey provides a comprehensive look at state Medicaid managed care programs, documenting their diversity, examining how states monitor access and quality, and exploring emerging efforts to improve care, including managed long-term care and initiatives targeted toward dual eligibles.

Short URL: http://www.advancingstates.org/node/52976

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Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS

Review this policy brief which summarizes 15 states' preliminary proposals to better coordinate care for people who are in the Medicare and Medicaid programs. The design contracts are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those of other Medicare and Medicaid beneficiaries.

Short URL: http://www.advancingstates.org/node/52957

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Helping Consumers Manage Long-Term Services and Supports in the Community: State Medicaid Program Activities

The Medicaid program is a source for many innovative practices in making long-term services and supports (LTSS) available to consumers. Case management services have been integral to Medicaid community-based LTSS programs since their inception, but as the programs have grown and evolved the functions performed by case managers have changed. This brief describes current case management efforts in states and activities and policies that can enhance states’ efforts to help consumers.

Short URL: http://www.advancingstates.org/node/52867


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