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Tag: Medicaid

Assessment of NCQA Medicaid MCO Quality Ratings Across Reporting Years 2025 and 2026

This edition conveys analyses of NCQA’s Medicaid health plan ratings, with a key focus on tabulating average ratings in each state and for each multi-state Medicaid organization.  All the averages calculated in this report are enrollment-weighted.
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Medicaid Community Engagement Requirements: Implications & Potential Activities for MCOs (Edition 2)

This edition examines what the H.R. 1 Medicaid community engagement requirements, also known as work requirements, mean for MCOs, covering the role CMS permits MCOs to play, implications for membership and financial performance, and potential activities to prepare before the…
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Medicaid Community Engagement Requirements: Overview of Federal Legislation & State Activities (Edition 1)

This edition provides a legislative and regulatory overview of the Medicaid community engagement requirements, also known as work requirements, established by H.R. 1 and slated to take effect January 1, 2027. This edition continues our work analyzing H.R. 1's impact.
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Rural Health Federal Funding: Impacts by Year; Medicaid’s Key Role in Rural Health (Edition 2)

This edition examines the Rural Health Transformation Program (RHTP) in the context of Medicaid and rural health, comparing the timeline of federal Medicaid reductions with RHTP investments and assessing how state-proposed initiatives align with key rural health indicators.
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Year One of the Rural Health Transformation Program Awards: Key Insights from Awards and Early Implementation (Edition 1)

This edition focuses on the Rural Health Transformation Program, the $50 billion fund established by H.R. 1 and distributed across all 50 states from FY26 through FY30.
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Assessment of NCQA Medicaid MCO Quality Ratings Across the Two Most Recent Measurement Years

This edition assesses changes and trends in NCQA Medicaid MCO quality ratings across measurement years 2023 and 2024.
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Assessment of HealthChoices, Pennsylvania’s Medicaid Managed Care Program

In this report and its accompanying summary documents, we evaluate the Physical HealthChoices program's performance across areas such as quality outcomes, cost management, collaboration between Pennsylvania's Medicaid agency and the MCOs, community investments, provider partnerships, and initiatives addressing social determinants…
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Timeline of Key Medicaid Provisions in One Big Beautiful Bill Act (OBBBA)

This edition summarizes major Medicaid changes in OBBBA, organized by implementation timeline, from 2025 to 2030. Key provisions introduce changes to eligibility, benefits, and state financing.
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Medicaid Expenditure Progression, 2013 – 2023

This edition quantifies the progression of Medicaid costs from 2013-2023 with a focus on the federal/state share of costs. Data are shown nationally, for each state and territory, and for various state groupings (regional, political, and by Medicaid Expansion adoption).
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Medicaid Expansion’s Impact on Prescription Drug Access

This edition examines the impact of Medicaid Expansion on prescription drug access, comparing prescription volume trends in 18 states that expanded Medicaid in 2014 with six non-expansion states. We look at overall prescription volume as well as three specific therapeutic…
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