Medicaid

This primer describes long-term services and supports (LTSS) delivery and financing in the U.S. and highlights covered services and supports, types of care providers and care settings, beneficiary subpopulations, costs and financing models, quality improvement efforts, and recent LTSS reform initiatives.

Research from the AARP Public Policy Institute/Urban Institute shows the uninsured rates for 50- to 64- year-olds dropped 31% between December 2013 and December 2014. In states that expanded their Medicaid programs, the drops were greater. The analysis uses preliminary data from the second open enrollment period of the Affordable Care Act.

This report reflects on Medicaid’s accomplishments and challenges and considers the issues on the horizon that will influence the course of this major health coverage and financing program moving forward. The report follows Medicaid’s evolution, including major legislative changes and other inflection points in the program’s history and analyzes how Medicaid threads through our health care system today and the measure of its impact.

This is one in a series of annual reports on participation in the Medicaid Buy-In program. It provides updates on both national- and state-level trends in enrollment, employment, and earnings among the 35 reporting Medicaid Infrastructure Grant (MIG) states with a Buy-In program in 2011. Additionally, it addresses recent changes to state program rules and policies, and identifies factors that have affected recent Buy-In program enrollment, as reported by the states in an annual questionnaire.

As part of PHI's One Vision: Moving Forward project, Michigan long-term care stakeholders discussed the potential use of Medicaid financial incentives to encourage person-centered care in nursing homes.The resulting publication outlines the ideas and recommendations produced by the discussion. The stakeholders primarily considered metrics, such as resident and staff satisfaction, that could be used to quantify nursing homes' commitment to person-centeredness.

This GAO report examines (1) the extent to which Medicaid enrollees have private insurance, and (2) the state and CMS initiatives to improve third-party liability (TPL). Given the findings in the report, GAO recommends that CMS routinely monitor and share information regarding key TPL efforts and challenges, as well as provide guidance on state oversight of TPL efforts conducted by Medicaid managed care plans.

As low-income adults covered under Medicaid expansion become eligible for and transition into Medicare, these individuals will face higher cost-sharing requirements. This report describes programs and policy options that could help low-income Medicare beneficiaries.

The Community First Choice (CFC) HCBS plan of California has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approved SPA pages of the California State Plan.

The Community First Choice (CFC) HCBS plan of Montana has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approval letter, summary form, and approved SPA pages of the Montana State Plan.

The Community First Choice (CFC) HCBS plan of Oregon has been approved by the Centers for Medicare & Medicaid Services. CFC is authorized under 1915(k) of the social security act, and is often called a 1915(k) state plan option. This file contains the approved SPA pages of the Oregon State Plan.