Medicaid

Everything from program structure, eligibility, services, financing and expenditures are covered here in concise summaries. This updated edition also contains graphics showing expenditures by service and the growth of Medicaid acute care spending as compared to private health plans. The tables at the end present data broken down by state. Refer to the 2007 version for historic perspective.

In 2005, VT became the first state to commit to a federal Medicaid funding cap in exchange for expanded eligibility definitions and access to home and community-based services under a Section 1115 waiver. Case studies and interviews are used to present key findings from the program. Key design features are also presented. Finally, future issues within VT and other states that might emulate the program are discussed.

This report provides a summary of how long-term services and supports (LTSS) are financed and describes factors that contribute to uncertainty of the future costs for LTSS, including changes in how LTSS will be delivered. Three projections of future LTSS spending for senior populations under different scenarios are offered. These scenarios differ based on projecting the number of people with varying functional limitations and the resulting need for varying degrees of LTSS.

This brief, the eighth in a series on working with disability, looks at the employment outcomes of participants in CommonHealth Working (CHW), Massachusetts’s Medicaid Buy-In program. Differences in post-enrollment employment rates, monthly hours worked and earnings, and private health insurance coverage are compared between new CHW enrollees previously covered by MassHealth, Massachusetts’s Medicaid program, and those without prior MassHealth coverage.

This is the eighth consecutive year that state Medicaid officials were surveyed to track program trends. In addition to data on expenditures and enrollment, the report outlines policy enhancements and restrictions in all states and the District of Columbia. The resource ends with a discussion of current key Medicaid issues and perspectives of State Medicaid Directors.

Determining how to optimally balance our demand for the best health care with limited funding represents one of the most challenging policy dilemmas facing the U.S. To help understand how to best accomplish this task, the document authors forecast Medicaid expenditures and enrollment for the next ten years. The data are organized by enrollment groups and service settings/categories.

The Medicaid Buy-In (MBI), Social Security Disability Income (SSDI), and Supplemental Security Income (SSI) programs all provide workers with disabilities options to maintain health coverage if they earn too much for Medicaid or Medicare benefits. The first issue brief explains how these programs compare and interact in terms of eligibility, coverage, populations, and enrollment. The second examines how MBI participants that collect SSDI utilize SSDI work incentives.

Answering the question posed in the title is one key to evaluating Medicaid Buy-In (MBI) programs. This issue brief, the fifth in a series on workers with disabilities, compares demographics, health status, and expenditures between these groups. Significant areas of difference that were identified are race, gender, diagnoses, and expenditures.

A recent trend in health care has been the increasing integration of behavioral health services into primary care settings. This paper discusses the benefits of such integration and the role of safety net primary care providers as behavioral health providers within the Medicaid program. The authors focus on organizational structure and reimbursement models in analyzing how four state programs achieve this integration.

This paper examines the use of research, demonstration, and program waivers as vehicles for innovation in the delivery and payment of health care and long-term care. It summarizes the context of the creation of the programs and reviews their legal underpinnings. It also analyzes the dynamics between state and federal authorities. Finally, the paper examines the impact of the Deficit Reduction Act of 2005 on the need for or desirability of waivers.