Medicaid

Facilitating a robust system of communication and coordination between medical and community service providers, an important goal of many health care delivery system reforms, is challenging for many states. With a variety of federal and state agencies sharing responsibility for child health and development, creating effective linkages among services is critical to optimizing outcomes. This […]

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  • State Health Policy Blog

    Last week the Centers for Medicare and Medicaid Services (CMS) released its long-awaited final rule outlining requirements for managed care organizations in Medicaid and Children’s Health Insurance Programs (CHIP). Preliminary NASHP analyses indicate that the final rule provides states with significant flexibility in making changes designed to modernize these federal programs as part of health […]

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  • Publications

    A growing number of states are administering Medicaid managed care contracts that include both medical and dental services. In 2015, Kentucky identified dental services as one of seven key areas where the state wanted to achieve measurable improvement in its Medicaid managed care contracts. This case study examines the history of dental managed care in […]

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    April 29, 2016 | Filed under: Front Page, Kentucky, Medicaid, Oral Health, Publications
  • State Health Policy Blog

    On April 25, the Centers for Medicaid and Medicare Services (CMS) released a long-awaited final rule that updates the regulations for managed care organizations in the Medicaid and Children’s Health Insurance Programs (CHIP). These new requirements represent the first major updates to Medicaid and CHIP managed care since 2002. In the intervening years, the percentage […]

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  • Publications

    As the scope of State Medicaid agencies becomes wider and more complex, states are increasingly turning to managed care organizations (MCOs) to cover Medicaid enrollees, including those with complex needs. This shift from a fee-for-service, volume-based payment model requires states to effectively manage MCOs and other vendors. With states facing tight budgets, limited staff, and […]

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    April 19, 2016 | Filed under: Front Page, Medicaid, Ohio, Payment Reform, Publications, Tennessee
  • Publications

    States are significant purchasers of health care for Medicaid, inmates in correctional facilities, and public employees. Despite considerable efforts to maintain affordability, drug pricing continues to vex state budgets. While Medicaid is the largest single health expenditure in state budgets, spending on health care for public workers including state employees and retirees, legislators, judicial employees, […]

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  • Publications

    States across the country are fully engaged in delivery system and payment reform efforts to improve care and lower costs in their Medicaid programs. Data is a critical component of these efforts. This NASHP brief provides an introduction to two types of Medicaid utilization data—fee-for-service claims data and managed care encounter data—and, based on examples […]

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  • State Health Policy Blog

    States that have implemented managed care in their Medicaid programs face the complex and time consuming task of reconciling managed care payments to federally qualified health centers (FQHCs) to ensure they are at, or above, their Prospective Payment System (PPS) rates. Several senior Medicaid officials raised this issue during a recent NASHP meeting on the […]

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    January 12, 2016 | Filed under: Front Page, Kentucky, Medicaid, State Health Policy Blog
  • Publications

    In the five years since the passage of the Affordable Care Act (ACA), 17 states and the District of Columbia have created health insurance exchanges and 30 states and the District have expanded their Medicaid programs to cover low-income populations.  More than 16 million people are newly insured under the law. In addition to expanding health coverage, […]

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  • State Health Policy Blog

    As 2015 comes to a close, Medicaid expansion activity in states has not slowed down. Currently, 30 states and the District of Columbia have expanded Medicaid, and six of these states have chosen to pursue waivers to implement alternative versions of expansion. As the new year approaches, a number of additional states are considering options […]

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