Medicaid

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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  • 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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  • Where States Stand on Medicaid Expansion Decisions
    Maps

    *Map updated July 10, 2017* This map tracks state Medicaid expansion decisions and approaches states are taking for expanding eligibility to 138 percent of the Federal Poverty Level (FPL). This map also includes information on state legislative activity around Medicaid expansion {1}, governors’ stances on the issue, and fiscal and demographic analyses from the state […]

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    March 14, 2016 | Filed under: ACA, Maps, Medicaid
  • 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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