Medicaid

The Centers for Medicare & Medicaid Services released their monthly report for October 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

The Centers for Medicare & Medicaid Services released their monthly report for September 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

This recently released report examines the reforms, policy changes, and initiatives that occurred in FY 2018 and those adopted for implementation for FY 2019. The report focuses on changes in eligibility, managed care and delivery system reforms, long-term services and supports, provider payment rates and taxes, covered benefits, and pharmacy and opioid strategies.

This study from Milliman highlights the success that MLTSS programs have had in reducing institutional care for older adults and people with disabilities compared to states operating a fee for service system, both in absolute numbers as well as the acuity level of consumers receiving services in nursing facilities.

The Centers for Medicare & Medicaid Services released their monthly report for August 2018 on Medicaid and CHIP application, eligibility determination, and enrollment data. This report includes point-in-time data from all 50 states and the District of Columbia, including the number of applications submitted directly to Medicaid and CHIP agencies, the number of eligibility determinations made on these applications, and the total number of individuals enrolled in the Medicaid and CHIP programs.

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2018 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

State Medicaid programs are increasingly opting to cover home and community-based services. This report looks at the efforts of various state Medicaid programs, examines their structure, and highlights the challenges encountered. From this review, GAO highlights three main challenges: 1) difficulty recruiting and retaining home care workers, 2) difficulty serving those with complex needs and, 3) limited funding for HCBS services.

Medicaid value-based payment (VBP) models tie payment to outcomes including quality of care, health status, and costs. This guide outlines considerations for adopting value-based payment (VBP) to promote high-quality MLTSS programs. It combines insights from five states - Minnesota, New York, Tennessee, Texas, and Virginia - with input from national health policy experts.

This report presents information on managed care’s enrollment and spending. It explores the growth of enrollment in Medicaid Managed Care in the United States and the contributing factors. It also analyzes the fact that funding does not directly parallel enrollment, as the share of total Medicaid spending that went to managed care only grew from 15 percent to 37 percent between 1999 and 2012, despite enrollment growing from 63 percent to 89 percent during that same time period.

This report examines the role of formal long-term services and supports (LTSS) in Medicaid. The report focuses on how sociodemographic changes will impact the demand for LTSS in the future, and as a result, Medicaid use and expenditures.