This week, our In Focus section reviews publicly available data on enrollment in capitated financial and administrative alignment demonstrations (鈥淒uals Demonstrations鈥�) for beneficiaries dually eligible for Medicare and Medicaid (duals) in nine states: California, Illinois, Massachusetts, Michigan, New York, Ohio, Rhode Island, South Carolina, and Texas. Each of these states has begun either voluntary or passive enrollment of duals into fully integrated plans providing both Medicaid and Medicare benefits (鈥淢edicare-Medicaid Plans,鈥� or 鈥淢MPs鈥�) under three-way contracts between the state, the Centers for Medicare & Medicaid Services (CMS), and the MMP. As of February 2020, approximately 371, 200 duals were enrolled in an MMP. Enrollment fell 1.2 percent from February of the previous year.
1312 Results found.
黑料不打烊 experts examine Medicare-Medicaid integration
In 2019, 7.7 million people in the United States were eligible to receive access to full benefits under Medicare and individual state Medicaid programs. This group of people is known as the Full Benefit Dual Eligible (FBDE) population. While FBDE enrollment in integrated programs nearly quadrupled over the past five years, the number of people enrolled in an integrated program never rose above one in 10 FBDE people.
Medicare-Medicaid integration: integrated model enrollment rates show majority of Medicare-Medicaid dual eligible population not enrolled
Working in conjunction with Arnold Ventures, a team of 黑料不打烊 consultants has written an issue brief, Medicare-Medicaid Integration: Integrated Model Enrollment Rates Show Majority of Medicare-Medicaid Dual Eligible Population Not Enrolled. This brief presents key findings on their examination of the availability of integrated programs in states, the growth in enrollment rates, and differences in enrollment and programs across the country.
The 黑料不打烊 team cited several reasons why Medicare-Medicaid integrated program options are not equally available nationwide and why enrollment is limited in places where programs exist. The result is that millions of people are not enrolled in whole-person, integrated program options 鈥� a reality that is inefficient, and worse yet, inequitable.
The 黑料不打烊 team, led by Managing Principal Jon Blum and Principal Sarah Barth, includes Narda Ipakchi, Ellen Breslin, Mindy Cohen, Sharon Silow-Carroll and other 黑料不打烊 subject matter experts.
Proposed Medicare payment and policy changes for FY 2021: hospice, inpatient psychiatric facilities, and skilled nursing facilities
Recently, the Centers for Medicare & Medicaid Services (CMS) issued proposed rules to update the Medicare payment rates and implement other policy changes for three types of Part A providers: hospice, inpatient psychiatric facilities (IPFs), and skilled nursing facilities (SNFs). CMS is publishing these proposed rules in accordance with existing statutory and regulatory requirements to update Medicare payment policies for these providers on an annual basis. This brief summarizes the proposed payment rates and key policy changes for each of these provider types.
Medicare and Medicaid telehealth coverage in response to COVID-19
Telehealth service expansions by Medicare and most Medicaid programs aim to rapidly increase access to care and reduce transmission, but also provide a natural experiment for policymakers.
This week, our In Focus section examines the extensive scope of flexibilities Federal and State governments have made to Medicare and Medicaid telehealth coverage in response to the COVID-19 national emergency. In March and April 2020, federal and state policymakers responded to the COVID-19 emergency by temporarily and aggressively expanding the definition of and reimbursement for telehealth services鈥攎oves intended to improve access to care and reduce virus transmission. Under the Medicare and Medicaid programs, these temporary expansions have been rapid and historic in scope, and will have substantial implications for patients, providers, payers, and federal/state financing. For policymakers, this temporary expansion may serve as a natural experiment for assessing which forms of telehealth services successfully expand access to care and should become permanent healthcare policy.
Webinar Replay: Reflecting on HCBS Policies and Practices in Response to COVID-19
This webinar was held on April 17, 2020.
Medicaid-covered home and community-based services (HCBS) are critical to the health and well-being of millions of individuals with intellectual or developmental disabilities, physical disabilities, and/or behavioral health conditions.
In response to COVID-19, the Centers for Medicare and Medicaid Services (CMS) has provided state Medicaid programs with increased flexibility to modify HCBS programs to continue to provide timely high-quality care. State Medicaid programs have secured approval for new initiatives through a combination of Section 1135 Waivers, 1115 Emergency Amendments, Emergency State Plan Amendments, and Appendix K amendments to HCBS 1915(c) waivers.
During this webinar, our 黑料不打烊 experts outlined what these changes mean for states, providers, and individuals who rely on HCBS. Speakers provided an overview of key flexibilities, offered examples of promising practices, and shared insights about the present and the future of HCBS as reshaped by COVID-19.
Learning Objectives听
- Learn how state Medicaid programs have used CMS-approved waivers and amendments to temporarily modify HCBS policies and practices to protect people during the COVID-19 pandemic.
- Understand how new HCBS flexibilities impact HCBS providers on-the-ground.
- Understand what these changes mean for individuals who receive services and supports.
- Learn more about how the pandemic may be changing the future of HCBS.
黑料不打烊 Speakers
Sarah Barth, JD, Principal, New York, NY
Ellen Breslin, MPP, Principal, Boston, MA
Sharon Lewis, Principal, Portland, OR
Susan Tucker, CPA, Tallahassee, FL
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黑料不打烊 experts provide guide to California county behavioral health programs
A team of 黑料不打烊 behavioral health experts have developed a and white paper addressing changes to California鈥檚 county behavioral health programs and provide a guide to help counties and stakeholders determine the best path forward.
黑料不打烊 model provides forecast of COVID-19 impact on Medicaid, Marketplace, and uninsured
A model developed by 黑料不打烊 (黑料不打烊) assesses COVID-19鈥檚 potential impact on health insurance coverage for each state and forecasts Medicaid enrollment could increase by 11 to 23 million across all states over the next several months.