Kaiser Family Foundation

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.

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.

The Medicaid program is a major payer for long-term services and supports (LTSS) in the United States, accounting for 40 percent of total spending for long-term services and supports. This brief highlights two important aspects of operations in states that affect access to LTSS in the community: efforts to provide accurate and timely information to consumers, and procedures to make Medicaid eligibility determinations quickly and efficiently.

Explore this brief for information on the main trends to emerge from the latest Medicaid expenditures and participant data for the three main Medicaid HCBS programs: (1) optional 1915(c) HCBS waivers, (2) the mandatory home health benefit, and (3) the optional state plan personal care services benefit. It also presents 2009 findings on the policies used in these three programs, including eligibility criteria, provider, service and waiting list data.

In July 2010, the Kaiser Commission on Medicaid and the Uninsured surveyed states about the current status of their Money Follows the Person (MFP) program including trends in enrollment, services and per capita spending. Explore the report for information on the findings regarding information on transitions back to the community, the average monthly cost of transitioning a MFP participant to the community, obstacles to transition, and more.

This report provides the latest national and state data on enrollment and spending for individuals enrolled in both Medicaid and Medicare, also known as dual eligibles. There were about 8.9 million dual eligibles in 2007. Dual eligibles are among the sickest and poorest individuals covered by either program. Although they comprised 15% of Medicaid enrollment, dual eligibles accounted for 39% ($121 billion) of Medicaid spending for medical services & for more than a quarter of Medicare spending.

The Kaiser Family Foundation's Commission on Medicaid and the Uninsured (KCMU) held a briefing to examine the challenges facing states as they continue to struggle with the lingering impacts of the recession and begin preparing to implement health reform. Find links to three reports released at the event, archived presentations, video, podcast, transcript, agenda and more.

To better understand the dynamics of the workforce challenges that factor in to the implementation of health reform, an initiative was undertaken to examine the situation in five states (Connecticut, Michigan, Massachusetts, North Carolina and Washington). These states represented a range of geographic and political experiences as they continued to struggle with the lingering impacts of the recession and began preparing to implement health reform. Six key findings are summarized.

Are you looking for state data on people who are simultaneously enrolled in Medicare and Medicaid? Find a number of useful interactive tables, charts, and graphs including Medicaid spending by service, spending per dual eligible, dual eligible enrollment, duals as a percentage of Medicaid enrollees, and more.

For the tenth consecutive year, a survey of Medicaid officials in all 50 states and DC was conducted to track trends in Medicaid spending, enrollment and policy initiatives. Findings are presented for FYs 2010 and 2011. As states grapple with historically difficult budget conditions, they must also plan for the implementation of the ACA. Review this report including background on the Medicaid program, as well as current issues the program faces.