Medicaid

Centers for Medicare and Medicaid Services (CMS) has provided funding and technical assistance to states to develop state plans' to coordinate care for dual eligibles, persons eligible for both Medicare and Medicaid. This chart shows the status of those states selected for the Dual Demonstration grants, the model chosen, and target implementation. It also includes links to each state's plan.

An Accountable Care Organization (ACO) is a provider-run organization in which the participating providers are collectively responsible for the care of an enrolled population. This brief examines the existing Medicaid payment and care delivery landscape in states undertaking Medicaid ACO initiatives to gain insights into how ACOs fit into states’ Medicaid programs, and to identify important differences between Medicaid ACOs and ACOs in Medicare and the private insurance market.

This brief explains how Medicare beneficiaries become eligible for Medicaid, provides national & state-by-state data on enrollment, & examines national & state-specific data on Medicaid spending for dual-eligible beneficiaries by service & eligibility group. The Foundation also has a collection of resources on dual-eligible beneficiaries, including basic facts & data, and analysis & explanation of specific issues, which include provisions of health reform affecting dual-eligible beneficiaries.

In 2014, most homeless people will become Medicaid-eligible under the Affordable Care Act. Many homeless people have physical and behavioral health conditions for which they seek care through frequent use of emergency rooms and inpatient hospitalization, at considerable cost in public resources. Medicaid reimbursement is an important source of funding for services that help homeless people succeed in housing and stop such inappropriate use of crisis health services.

This portion of the Center for PAS website presents various data and resources related to Personal Assistance Services by state. Recent updates include two sets of information concerning Medicaid home-and community-based services (HCBS). Users can select a state or select a specific topic such as state statistics, program data, and other PAS projects.

The goals of the survey, which was sent to direct-care workers serving participants using the MI Choice SD option, were to: collect baseline demographic information on workers in the SD option; understand the motivations, job satisfaction, and training needs of workers providing services and supports to self-directed participants; and,identify strategies to strengthen and support the recruitment and retention of workers in self-directed programs.

This report describes the process of assembling and integrating Medicaid and Medicare data to study recipients of HCBS in California. Subsequent reports will describe disability levels and service use of HCBS users in Medi-Cal only and dual eligibles between 2005 and 2008.

This policy brief from Georgetown University, produced with support from The SCAN Foundation, reviews Medicaid's importance and current funding limitations for long-term care and makes the case for strengthening Medicaid two possible ways - full federal responsibility for Medicare beneficiaries who also rely on Medicaid or an enhanced federal match for Medicaid long-term care services. Each approach carries with it a federal commitment to bear the brunt of a growing elderly population.

Both of these large state waivers affect hundreds of thousands of Medicaid beneficiaries, involve billions of federal Medicaid matching funds, and are designed, in part, to promote changes in the health care delivery system that will result in better care for individuals, better population health, and reductions in costs through system improvements. They have a number of key similarities and differences as summarized in the side-by-side table within this fact sheet.

Medicaid program integrity is among the highest priorities of the nation’s Medicaid Directors and is a key component of every initiative and program states conduct. Program integrity is about creating a culture where there are consistent incentives to provide better health outcomes within a context that avoids over-or underutilization of services. Directors seek to promote economy, efficiency, accountability, and integrity in the management and delivery of services.