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The Role of Medicaid Managed Care In Delivery System Innovation

April 8, 2014

States are increasingly turning to Medicaid managed care as a key strategy to manage costs and encourage innovation in health care delivery. This report examines health care providers' perspectives on the role of managed care in improving health services for low-income adults in four communities: Milwaukee, Wisconsin; Oakland, California; Seattle, Washington; and Washington, D.C. It finds that providers do not generally perceive Medicaid managed care as a catalyst for delivery system reform. Fragmented delivery systems, limits on the types of services for which managed care organizations are at risk, and the volatility in managed care markets all present challenges to improving care delivery. Policy and operational changes could enhance the role of Medicaid managed care in promoting patient-centered, coordinated, and high-quality care.

Activities to Promote Quality In Florida’s Medicaid Managed Long-Term Care Program

December 6, 2013

Florida's new Medicaid Managed Long-Term Care (LTC) Program has two broad goals – improvingservice quality and cutting costs – that some observers think may not always be compatible. Strongoversight and the availability of timely information about program performance and beneficiaryexperience can help ensure that quality services are delivered even as savings are achieved. Information about how beneficiaries, providers and plans are faring is essential to efforts to refine and improve program operations. Data on plan performance also can be used to help beneficiaries make informed choices among competing managed care organizations.This publication provides general guidance related to planning, sponsoring and conductingLong-Term Care program monitoring activities. It also describes methods and measures that can be used to answer specific questions that stakeholders have raised about Florida's Medicaid Long-TermCare program.

Launch of Medicaid Managed Long-Term Care In Florida Yields Many Lessons for Consideration

December 5, 2013

In August 2013, Florida began the first phase of mandatory enrollment in Medicaid's new Managed Care Long-Term Care program.While some Medicaid beneficiaries already had been receiving long-term care services through managed care plans, the mandatory transition of large numbers of consumers who use long-term care services – the elderly and young adults with disabilities – from fee-for-service to managed care is unprecedented.This brief describes the first phases of implementation and provides recommendations that could help community organizations, health advocacy groups and the State of Florida, ensure optimal outcomes. These recommendations can guide the continued phase-in of the new Long-TermCare program, as well as be useful as Florida prepares to implement the Medicaid Managed Medical Assistance Program for acute care services in 2014.The brief draws on interviews with a variety of stakeholders across the state. In addition to lifting up common concerns, the brief highlights issues to consider and offers suggestions for continuing operations in three program areas: plan choice and enrollment, the availability of services and quality assurance.

Proposed Medicaid Long-Term Care Changes Raise Host of Questions About Impact

January 18, 2012

Outlines proposed changes to Florida's Medicaid Long-Term Care program, possible consequences, and implementation challenges such as limited time and resources, program features that may not transfer easily, and the need for strong independent oversight.

Increasing Participation in Benefit Programs for Low-Income Seniors

May 4, 2009

Reviews research on barriers to eligible low-income seniors' participation in programs such as food stamps and Medicaid: lack of knowledge and complex procedures. Suggests simplified applications, a person-centered approach, and investment in technology.

Getting and Keeping Coverage: States' Experience With Citizenship Documentation Rules

January 12, 2009

Explores the impact of the 2006 requirement to show proof of citizenship to enroll in Medicaid or other public health insurance on the stability of coverage for eligible children and families, efforts to simplify processes, and costs in seven states.

Medicare Part D: How Do Vulnerable Beneficiaries Fare?

May 1, 2008

Based on a survey of counselors, program managers, and health workers, outlines the need to provide user-friendly information, facilitate enrollment and plan choice, and improve monitoring and counseling for the prescription drug benefit's beneficiaries.

Improving the Medicare Part D Program for the Most Vulnerable Beneficiaries

May 1, 2007

Discusses some of the obstacles patients experience using Medicare Part D and makes specific recommendations to strengthen the program, such as using simpler, more standard procedures and ensuring that needed counseling support is provided.

Demography Is Not Destiny, Revisited

March 1, 2005

Looks at the impending demographic challenges of the aging American population. Considers the impact of factors in addition to anticipated changes in the size and age distribution, particularly those related to the economy and public policies.

Demography Is Not Destiny

January 1, 1999

Examines demographic and economic trends, and other challenges and opportunities associated with the aging American population. Highlights the interactions that occur among public programs, private institutions, and individuals. Discusses policy options.