- ACA Implementation & State Health Reform
- Coverage and Access
- Federal/State Issues
- Medicaid and CHIP
- Population and Public Health
- Providers and Services
- Acute Care
- Assisted Living
- Behavioral Health
- Case Management
- Child Development Services
- Chronic Care Management
- Community Health Centers
- Developmental Screening
- Early Childhood Services
- Emergency Care
- EPSDT
- Family Planning
- Federally Qualified Health Centers
- Home & Community Based Services
- Hospitals
- Long Term Services & Supports
- Medical Homes & Health Homes
- Mental Health
- Nursing Homes
- Oral Health
- Preventive Care
- Primary Care
- Safety Net Providers
- Quality, Cost, and Health System Performance
- ACOs
- Adverse Event Reporting
- Care Transitions
- Comparative Effectiveness
- Cost Sharing
- Delivery System Reform
- Fraud and Abuse
- Health Care Workforce
- Health Information Technology
- Managed Care
- Medical Homes & Health Homes
- Medical Malpractice
- Patient Safety
- Payment Reform
- Performance Measurement
- Provider Payment Policy
- Quality Oversight
- Specific Populations
- Adolescents
- Childless Adults
- Children
- Children with Special Health Care Needs
- Dual Eligibles
- Elders
- Families
- Low Income People
- Parents
- People with Chronic Conditions
- People with Developmental Disabilities
- Transitional Youth
- Vulnerable Populations
- Young Adults
- Youth
- Youth in Foster Care System
- Youth in Juvenile Justice System
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Managed Care for Low Income Elders Dually Eligible for Medicaid and Medicare
Low income older people are frequently eligible for both Medicare and Medicaid. Approximately six million Medicaid beneficiaries also participate in the Medicare program. Dual eligibles are aged, blind or disabled individuals who qualify for both Medicare and Medicaid. Most, but not all, SSI beneficiaries and Medically Needy Medicaid beneficiaries also participate in Medicare. This paper focuses on elderly dually eligible beneficiaries.
June 1997» -
Quality Improvement Standards and Processes Used by Select Public and Private Entities to Monitor Performance of Managed Care Plans
Over the past several years, HCFA's Medicare and Medicaid offices have been engaged in concurrent initiatives to design and implement standards and strategies for quality improvement under managed care arrangements.
April 1995» -
A Guide to Federal Programs for People with Disabilities
There are scores of federal programs for persons with disabilities. The National Academy for State Health Policy has prepared the Guide to Federal Programs for Persons with Disabilities as a resource for federal and state policy makers. The guide offers an overview of 129 programs.
The primary source of information for the Guide was the Catalog of Federal Domestic Assistance (1993 and 1994). Other materials reviewed include the United States Code, various publications by the Congressional Research Office, and the Preliminary Status Report of the Disability Policy Panel (March 1994).
December 1994» -
Managed Care for the Elderly: A Profile of Current Initiatives
The purpose of this document is to summarize the current state-of-the-art in managed care for the elderly and to provide states with background information needed to launch their own initiatives to provide quality, cost effective care to the rapidly aging population. As you will see, attempts to truly coordinate primary, preventive, acute, and long term care have been limited, but the demonstrations that do exist show promise. As the health care reform debate unfolds, it is likely that states will seek to do more to manage care for the elderly, and we hope this document provides useful, baseline information.
November 1993» -
Protecting Low Income Beneficiaries of Medicare and Medicaid in Managed Care
Volume I: Contracting Arrangements, Beneficiary Choice, Enrollment and Disenrollment, and Tracking
These papers were prepared prior to the passage of the Balanced Budget Act of 1997. The Act makes significant changes that will affect managed care programs for dually eligible beneficiaries. However, the specific impact cannot be fully determined until regulations are drafted by HCFA.
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Examining a Major Policy Shift: New Federal Limits on Medicaid Coverage for Children
This State Health Policy Briefing explores recent decisions by the Centers for Medicare and Medicaid Services (CMS) which have serious implications for states striving to expand health coverage for children. Download available here.April 2008 -
Money Follows the Person Demonstration: Covering Case Management Services
The Centers for Medicare and Medicaid Services awarded Money Follows the Person demonstration grants to 31 states in 2007. This brief describes the options for covering case management or transition coordination for these projects and describes the potential impact of pending changes to case management coverage resulting from the Deficit Reduction Act of 2005. A joint publication of the Rutgers Center for State Health Policy and the National Academy for State Health Policy. Published for the Community Living Exchange, funded by the Centers for Medicare & Medicaid Services (CMS).September 2007 -
Making Medicaid Work for the 21st Century: Medicare and Medicaid Dual Eligibles
One of a series of issue briefs designed to share with federal and state policymakers, as well as other stakeholders, the issues and options raised by the Making Medicaid Work for the 21st Century workgroup. This brief discusses ways to improve care coordination and reduce the cost of Medicare and Medicaid dual eligibles.April 2004 -
Hawaii
In May 2011, Hawaii Governor Neil Abercrombie announced his administration’s intent to secure medical homes for Hawaii’s 270,000 Med-QUEST (Medicaid) beneficiaries. Integrating behavioral health and social services with primary care will be a major goal of the state’s medical home efforts.Hawaii is currently working to develop and obtain approval for a health homes state plan amendment (SPA). A State Plan Option Collaborative has been meeting to select chronic conditions to focus on, define what “health home” will mean in Hawaii, reach consensus on culturally competent health home service definitions, agree on a payment methodology, and identify key measures to track. The state is now carrying out a workplan for developing the health homes SPA. -
South Carolina
In early 2011, the Centers for Medicare & Medicaid Services (CMS) approved South Carolina’s request to expand its Healthy Connections Choices program to require that most beneficiaries enroll in managed care. Healthy Connections Choices enrollees have the option to join a managed care plan or a a primary care case management program known as the Medical Homes Network Program.
