Clear all

12 results found

reorder grid_view

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.

Medicaid Managed Care in Florida: Federal Waiver Approval and Implementation

October 7, 2013

Florida's new Medicaid plan -- called the Managed Medical Assistance program -- will move nearly all of the state's Medicaid beneficiaries into managed-care plans. This new plan, approved in June 2013, is the final chapter in a Medicaid reform effort that is almost a decade old. Drawing on experiences from that decade of experimentation, the new plan incorporates significant consumer protections, some unique to Florida. Most of these protections establish the need for ongoing oversight and public input, creating opportunities for stakeholder monitoring and comment

Plan Management: Issues for State, Partnership and Federally Facilitated Health Insurance Exchanges

May 10, 2012

Examines the state's plan management function of insurance exchanges under federal healthcare reform, including overseeing the licensing and solvency of plans, network adequacy, benefit and rate review, marketing and regulation, quality improvement.

Premium Incentives to Drive Wellness in the Workplace: A Review of the Issues and Recommendations for Policymakers

February 27, 2012

Outlines trends in workplace wellness programs; healthcare reform law provisions allowing greater financial incentives for employees; policy considerations for vulnerable populations, privacy issues, and affordability of coverage; and recommendations.

The Role of Exchanges in Quality Improvement

September 28, 2011

Explores state options and considerations for driving healthcare quality improvement and delivery system reform at the plan and provider levels through insurance exchanges, including the need to involve all stakeholders in developing and executing policy.

Active Purchasing for Health Insurance Exchanges

June 3, 2011

Examines the extent to which exchanges could be active purchasers that contract selectively with carriers, set stricter criteria, or negotiate discounts to leverage high-quality, affordable coverage, and not simply provide the broadest array of plans.

Program Design Snapshot: State Buy-In Programs for Children

November 25, 2008

Outlines the features, impact, and possible limitations of programs that allow moderate-income families without access to affordable private health insurance to buy public coverage for their children. Includes suggestions for increasing enrollment.

Family Coverage: Covering Parents Along With Their Children

September 30, 2008

Explores the high uninsured rate among parents compared to children, due to the lack of both employer-sponsored and public insurance options. Argues for expanding state Medicaid coverage to parents. Offers strategies for addressing costs and other issues.

Program Design Snapshot: 12-Month Continuous Eligibility

September 30, 2008

Calls for wider implementation of a state option allowing children to maintain Medicaid or State Children's Health Insurance Program eligibility for a full year, even if their family status or income changes. Lists issues to consider as well as resources.

Program Design Snapshot: Public Coverage Waiting Periods for Children

September 30, 2008

Reviews requirements that children be uninsured for a specified period before enrolling in State Children's Health Insurance Programs. Considers the potential harm of waiting periods, effectiveness in deterring private coverage crowd-out, and exceptions.

Cost Sharing for Children and Families in Medicaid and SCHIP

September 30, 2008

Reviews research on current cost-sharing practices and their effect on enrollment in Medicaid and State Children's Health Insurance Programs (SCHIP). Suggests ways to develop premium and cost-sharing policies that ensure coverage for low-income families.