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Full-Text Articles in Health Policy
A New State Plan Option To Integrate Care And Financing For Persons Dually Eligible For Medicare And Medicaid, Jane H. Thorpe, Katherine J. Hayes
A New State Plan Option To Integrate Care And Financing For Persons Dually Eligible For Medicare And Medicaid, Jane H. Thorpe, Katherine J. Hayes
Health Policy and Management Faculty Publications
As health care costs continue to escalate, Congress, the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), state Medicaid agencies, researchers, and policymakers are focusing on identifying new approaches to care delivery and reimbursement for individuals who are dually eligible for both Medicare and Medicaid. Although relatively few in number (9 million), dual eligible beneficiaries are more likely than others to experience poor health, including multiple chronic conditions, functional and cognitive impairments, and a need for continuous care. Sixty-six percent of dual eligibles have three or more chronic conditions; sixty-one percent are …
Medicaid And Access To Health Care--A Proposal For Continued Inaction?, Sara J. Rosenbaum
Medicaid And Access To Health Care--A Proposal For Continued Inaction?, Sara J. Rosenbaum
Health Policy and Management Faculty Publications
No abstract provided.
Medicaid And Access To The Courts, Sara J. Rosenbaum
Medicaid And Access To The Courts, Sara J. Rosenbaum
Health Policy and Management Faculty Publications
The Medicaid program is grounded in a statute that is one of the most complex of all federal laws. An insurer of more than 60 million people — and poised to begin serving 16 million more by 2019 — Medicaid will be reexamined this year, in all its legal complexities, by the U.S. Supreme Court, which has agreed to hear California's appeal in the case Maxwell-Jolly v. Independent Living Center of Southern California. The Court's ruling could fundamentally alter states' accountability to beneficiaries and providers when their official conduct allegedly violates Medicaid's essential federal requirements.
Medicaid Statistical Information System (Msis): A Data Source For Quality Reporting For Medicaid And The Children's Health Insurance Program (Chip), Patricia Mactaggart, Ashley Foster, Anne R. Markus
Medicaid Statistical Information System (Msis): A Data Source For Quality Reporting For Medicaid And The Children's Health Insurance Program (Chip), Patricia Mactaggart, Ashley Foster, Anne R. Markus
Health Policy and Management Faculty Publications
Section 401 of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) requires the Department of Health and Human Services (HHS) to identify and publish healthcare quality measures for children enrolled in the Children's Health Insurance Program (CHIP) or Medicaid. CHIPRA also requires core measures to identify disparities by race and ethnicity, among other factors. State Medicaid and CHIP programs are currently facing significant budgetary pressures that are likely to increase with eligibility expansions and programmatic changes resulting from the Patient Protection and Affordable Care Act (PPACA). To limit the burden on states and increase the likelihood of states' …
The States' Next Challenge--Securing Primary Care For Expanded Medicaid Populations, Leighton C. Ku, Karen Jones, Peter Shin, Brian K. Bruen, Katherine J. Hayes
The States' Next Challenge--Securing Primary Care For Expanded Medicaid Populations, Leighton C. Ku, Karen Jones, Peter Shin, Brian K. Bruen, Katherine J. Hayes
Health Policy and Management Faculty Publications
In the coming years, the United States must address both an expansion of Medicaid coverage and an unexpected shortage of primary care physicians. Under the Patient Protection and Affordable Care Act (ACA), the Medicaid eligibility threshold for nonelderly adults will rise to 133% of the federal poverty level (about $30,000 for a family of four) in 2014. States with restrictive Medicaid eligibility requirements and high rates of uninsured residents will expand coverage substantially, while programs in states with higher current Medicaid eligibility thresholds and fewer uninsured residents will grow less. However, since many of the states with the largest anticipated …
Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges, Benjamin D. Sommers, Sara J. Rosenbaum
Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges, Benjamin D. Sommers, Sara J. Rosenbaum
Health Policy and Management Faculty Publications
The Affordable Care Act will extend health insurance coverage by both expanding Medicaid eligibility and offering premium subsidies for the purchase of private health insurance through state health insurance exchanges. But by definition, eligibility for these programs is sensitive to income and can change over time with fluctuating income and changes in family composition. The law specifies no minimum enrollment period, and subsidy levels will also change as income rises and falls. Using national survey data, we estimate that within six months, more than 35 percent of all adults with family incomes below 200 percent of the federal poverty level …