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Tag: Medicaid

Coordinated Care- Bringing Key Components Together

This edition explores the dynamics of optimal coordinated care, in relation to governmental policies/actions and MCO operational activities.  There are several combinations of ways that optimal care coordination programs are not yet being achieved. The construct described may be useful in…
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NCQA State Averages for Medicaid, Medicare, and Private Health Plans

This edition of the Series tabulates state average NCQA quality scores across the health plans that have been rated by NCQA.  Separate averages have been calculated for Medicaid health plans, Medicare plans, and private plans.
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Medicaid Health Plan NCQA Quality Rankings

This edition of the Series focuses on Medicaid MCO quality ratings, working with the data NCQA publishes each year.  These slides calculate average quality scores in each of the 33 states with at least one NCQA-ranked plan.  We also ranked…
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Medicaid Costs by Service 2007-2010

This month's 5-Slide Series examines CMS' MSIS database to tabulate Medicaid costs across 18 service categories between 2007 and 2010. Capitation as a portion of total Medicaid expenditures increased 6.0 percentage points from 2007-2010. Additionally, capitation spending increased 57% from…
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Nursing Home and Institutional Care – Medicaid Costs

This edition of the 5-Slide Series examines CY 2010 national Medicaid expenditures in the institutional setting. Nursing Homes, ICF/MR, and Mental Health Facilities collectively represented about one-fifth of national Medicaid expenditures. Dual eligibles accounted for 88% of nationwide Medicaid nursing…
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Persons with Disabilities – Medicaid Per Capita Costs

This edition of our 5-slide series examines Medicaid per capita costs for individuals with disabilities and provides recommendations for how to manage this population. 22.1% of nationwide spending for disabled non-duals was paid via capitation during 2010 (versus 50.2% for…
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Dual Eligibles – Demographics

This edition of our 5-slide series portrays dual eligible demographics, showing the number of duals in each state broken out between full duals and partial duals. We also show the percentage mix of duals in each state by gender and…
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Foster Care – Demographics and Costs

This edition provides demographic and cost information in children in foster care state by state along with nationwide totals. On average during 2010, 885,000 foster children were covered by Medicaid. Average Medicaid costs per foster child were $6,476 in 2010,…
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Capitation in Medicaid Past Trends and Future Growth Projection

This edition of the 5-Slide Series presents the evolution of the capitation model in Medicaid.
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