Medicaid

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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  • Webinars

    Many individuals involved in the criminal justice system are now eligible for Medicaid in states that expanded the Medicaid program under the Affordable Care Act. Health coverage can provide individuals who are leaving incarceration with access to physical and behavioral health services critical to their successful reentry into the community. In some states, correctional agencies have partnered with Medicaid agencies to implement procedures to begin the Medicaid application process as individuals are nearing their incarceration release dates. This webinar features three states—Colorado, New Mexico and Wisconsin—that have initiated efforts to enroll justice-involved individuals in health coverage.

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    November 4, 2015 | Filed under: Colorado, Medicaid, New Mexico, Webinars, Wisconsin
  • State Health Policy Blog

    States are developing new ways to pay Medicaid providers based on quality and efficiency over number of visits. However, these payment options can present challenges for states in integrating safety net providers into their efforts. In Oregon, Medicaid and the state’s Primary Care Association (PCA) have embarked on an alternative payment model that is breaking […]

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    September 14, 2015 | Filed under: Medicaid, State Health Policy Blog
  • Publications

    One of the central elements of the Affordable Care Act (ACA) is to establish “one-stop shopping” through health insurance marketplaces allowing consumers to find and access affordable, high-quality health coverage either through private health insurance, and the subsidies available for those who qualify, or through Medicaid. The ACA and related regulations define a spectrum of marketplace […]

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  • Last month, as part of an Academy Health Annual Research Meeting panel on the 50th anniversary of Medicaid, NASHP Executive Director Trish Riley gave remarks on the history of the program, as well as addressed where it is heading and the long-term relationship between Medicaid and the states. Read the entire speech here.  

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    July 21, 2015 | Filed under: All, Medicaid, News & Media, Press Release
  • On May 26, the Centers for Medicare & Medicaid Services (CMS) released a notice of proposed rule making (NPRM) that, once adopted as final regulation, represents the first major update to the rules governing Medicaid managed care since 2002. Since this time, Medicaid managed care has expanded in both scope and nature, with a considerable […]

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