Improving Systems
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It’s Time to Shed More Light on State Medicaid Quality
by Jon Peacock and Sashi Gregory, Wisconsin Council on Children and Families Last week was Sunshine Week, the annual nationwide celebration of access to public information. Now that the celebrating is over, perhaps it’s a good time to bring up an area where Wisconsin needs to let in considerably more sunshine – health care quality measures…
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A Primer on Health Care Quality Measurement and Improvement for Children in Medicaid and CHIP
When I was the CHIP Director in New Hampshire, we thought that achieving a 95% rate of coverage for kids was the high bar. As a country, we are not only closing in on that goal, but leading states have raised the bar to 98% and beyond. And while we must continue to eliminate disparities…
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Measuring and Improving Health Care Quality for Children in Medicaid and CHIP: A Primer for Child Health Stakeholders
A large body of evidence shows that, compared to low-income uninsured children, Medicaid has been highly successful in providing children with a usual source of care and regular well-child care while significantly reducing unmet or delayed needs for medical care, dental care, and prescription drugs due to costs. Nonetheless, quality improvement centers on the notion…
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Improving Health Care Access for American Indians and Alaska Natives
by Jesse Cross-Call, originally posted on cbpp.org An updated policy for how the federal government helps finance the costs of Medicaid services for American Indians and Alaska Natives will improve the delivery of care and save states money. Medicaid plays a critical role in providing health care to American Indians and Alaska Natives; a quarter…
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Why is North Carolina Getting Rid of Medicaid Managed Care Plan that Saves State Money?
Policymakers in many states have turned more and more to private managed care insurers to manage their Medicaid programs. More than half of people on Medicaid across the country are in some sort of “risk-based managed care organizations (MCOs)” and 39 states – according to comprehensive research by the Kaiser Family Foundation – use such…
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Medicaid Managed Care Regs Released – Let the Reading Begin
While we all breathed a collective sigh of relief when CMS did not release the Medicaid and CHIP Managed Care proposed rules prior to the Memorial Day weekend, we have our work cut out for us the next few weeks (months) as CMS released 653 pages of proposed rules late yesterday. Organizations have until July 27th…
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Child Emergency Room Visits as a Window into the Larger Landscape of Child’s Health Coverage
By Naomi Stark, Georgetown CCF Research Assistant The CDC’s National Center for Health Statistics (NCHS) recently published a report on Emergency Room (ER) use among children in the U.S. using data gathered from the 2012 National Health Interview Survey (NHIS). Authors explored the relationship of child coverage type (Private, Medicaid and Uninsured) to the frequency…
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Washington Reduces Medicaid in Emergency Departments – Credit to Seven Best Practices?
By Keanan Lane, CCF Research Intern & McCourt School of Public Policy Graduate Student The recently released findings from the Oregon Health Insurance Experiment have renewed focus on Medicaid coverage and emergency department (ED) utilization. The results showed an overall increase in ED visits, driven primarily by those classified as “non-emergent,” “primary care treatable,” and…
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Medicaid Access: Increased Demand for Primary Care Providers Will Vary Across Country
By Tara Mancini See CCF’s latest fact sheet on Medicaid Access Earlier this week, my colleague, Joan Alker, blogged about how Medicaid provides access to needed care. As she mentioned, the decision to extend Medicaid coverage to millions of the uninsured has often been met with skepticism over whether the health care system has the…
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New Resources from CCF Shows Medicaid Provides Access to Needed Care
A perennial question that is raised about Medicaid is whether beneficiaries can actually find doctors to access the care they need. A new factsheet from CCF on access to health care summarizes available research which shows that in general the answer is a resounding yes. Studies have consistently found that access to primary and preventive…
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The Election Results Are In: Now What Happens with the Affordable Care Act?
(Editor’s Note: We welcome Senator Rockefeller’s Senior Health Policy Aide Sarah Dash to Georgetown University’s Health Policy team. She is joining our colleagues at the Center on Health Insurance Reforms where she will direct a 50-state evaluation of state health insurance exchange implementation and its impact on access to affordable, high-quality health care. She will also…
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What Do We Know About Managed Care in Medicaid?
By Joe Touschner Managed care has been part of the Medicaid landscape for many years. Those of us who focus on children and families enrolled in Medicaid are particularly familiar with it—the overwhelming majority of kids in Medicaid are in managed care as are most of the adults who are not elderly or experiencing disabilities. …
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Study Finds Medicaid Beneficiaries’ Use of Hospital Emergency Departments Comparable to Privately Insured Patients
By Tara Mancini Medicaid seems to be a lightening rod for inaccurate assumptions such as it’s too expensive for states (it’s a good deal for states), overall cost (more cost-effective than private insurance) and beneficiaries using hospital Emergency Departments for routine care. Until recently, there had not been much research to refute the perception of…
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Medical Homes: Local Focus, Better Health
As policymakers across the country look to balance their budgets, some are turning to Medicaid, recycling the same harmful policies they’ve used year-after-year: eliminating coverage for vulnerable Americans, restricting critical benefits like prescription drug coverage, imposing premiums on those who can’t afford them, and slashing already-low provider reimbursement rates. Community Catalyst and Georgetown University Health…
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Decisions, Decisions: ACOs in Medicaid
By Tara Mancini Accountable Care Organizations (ACOs) have been in vogue for some time when it comes to coordinating care for Medicare patients; however, it is a relatively novel ideal for managing Medicaid populations. The populations covered by Medicaid differ vastly from that of Medicare, and therefore Medicaid ACOs require some different practices. A new…
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Holding Insurers Accountable: Should We Add an MLR to Medicaid?
A hot issue in many states today is whether or not to move more Medicaid beneficiaries, and often very vulnerable beneficiaries, into managed care. Indeed, many managed care companies are interested in getting or keeping a foot in the Medicaid market given the expansion of Medicaid coming in 2014. And many, though not all, states are…
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Examining Medicaid Managed Long-Term Service and Support Programs: Key Issues To Consider
By Laura Summer, Georgetown University Health Policy Institute (Editor’s Note: Given the increasing interest in Medicaid managed care among states eager to achieve cost-savings, we asked our colleague Laura Summer to blog for us on her latest report on managed care. Her report focused on long-term care services but it provides some helpful insights into broader…
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Looking Ahead to 2012, What Changes Are In Store for Florida’s Medicaid Program?
Medicaid is a critical part of Florida’s health care system. It covers 3.1 million people in the state, the majority of whom are children. In 2006, a five-year pilot program that replaced traditional Medicaid with an unusual managed-care model and other features that required a Section 1115 waiver from the federal government. In 2012, there…
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A Team Approach to Care
As policymakers across the country look to balance their budgets, some are turning to Medicaid, recycling the same harmful policies they’ve used year-after-year: eliminating coverage for vulnerable Americans, restricting critical benefits like prescription drug coverage, imposing premiums on those who can’t afford them, and slashing already-low provider reimbursement rates. Community Catalyst and Georgetown University Health…
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New Resources on Medicaid Managed Care
By Martha Heberlein States may choose to adopt managed care in Medicaid for a number of reasons. For example, they may be interested in improving care management and coordination. Others may wish to gain more predictability in spending or increase accountability for access to providers and quality of care. No matter what the reason (or…