On November 1, CMS posted on its website Medical Loss Ratios (MLRs) for individual Medicaid managed care organizations (MCOs) in 2018, 2019, and 2020. These data come from the MLR Summary Reports that states are required to submit to CMS. This CMS action follows the posting on July 15 of the first tranche of Managed […]
Another quarter, another round of earnings reports from the “Big Five.” The story of Q3 continues the basic narrative of Q1 and Q2. For all but one of the companies that dominate the Medicaid managed care market, net Medicaid enrollment continued to decline, driven primarily by the PHE unwinding. There is one new wrinkle, however. […]
A group often overlooked in Medicaid coverage conversations is foster youth. While they are a small segment of the population, youth aging out of foster care have higher physical and mental health care needs than their peers, but often lack health insurance due to high costs. The authors of the Affordable Care Act (ACA) took into […]
As discussed in our blog series on the CMS’s new EPSDT guidance, the 57 page state health official letter lays out a number of policies and strategies to help states meet their EPSDT requirements under Medicaid – including care for children with behavioral health needs. As you may recall, in 2022, CMS released an informational […]
As of June 2024, a paltry 4,231 Georgians were enrolled in Georgia’s section 1115 Medicaid waiver, according to reports from the state recently posted by federal CMS. Data from the newly released reports confirm that Governor Kemp’s “Pathways to Coverage” alternative to the Affordable Care Act’s Medicaid expansion – approved during the last year of […]
By Kay Johnson For more than 30 years, the federal Healthy Start program has been investing in community-based solutions to reduce maternal and infant mortality in communities with infant mortality rates at least 1.5 times the U.S. national average. At a time when many are rightly calling for more community and family engagement to reduce […]
