Tag: Medicaid
This edition of our Five Slide Series is Medicare-focused, policy-oriented, and qualitative and opinionated in nature. We report on the achievements the Medicaid program has made in the mandatory enrollment MCO model, and convey our thoughts on testing a similar approach in Medicare.
- Keywords: Enrollment Medicaid Medicare Policy
This edition of our Five Slide Series focuses quantitatively on Medicaid’s “footprint” in terms of the proportion of the country’s population served by the program by age, gender, and race. Our finding agree with the national consensus; Medicaid plays a disproportionately large role in covering our youngest residents, women, and many minority subgroups.
- Keywords: Enrollment Medicaid
This edition of the Five Slide Series estimates the amount each states’ residents are paying for the Medicaid expansion population’s coverage – whether or not their state is participating in the coverage program. In the aggregate, we estimate that an annual financial transfer of $17 billion is occurring from the residents of the non-expansion states to the residents of the expansion states. A state not yet participating in the expansion can move its residents from collectively being large-scale net losers to a large-scale net gainers by opting to participate.
- Keywords: Expansion Expenditures Medicaid
This edition assesses the 2014 NCQA Medicaid MCO quality scores. Analysis includes calculation of statewide average scores for all plans, top performing MCOs relative to their state’s average, comparisons by ownership (such as publicly traded versus non-publicly traded MCOs), and trends for scores from 2013-2014.
This edition looks at Medicaid eligibility trends, including stability in Medicaid coverage. We also find States with managed care tend to offer more stable Medicaid than FFS States.
- Keywords: Medicaid
This edition looks at Medicaid and Medicare combined costs. Nationwide, 2009 combined claims-based spending on Medicaid and Medicare represented approximately $800 billion in overall outlays, excluding most disproportionate share (DSH) and upper payment limit (UPL) supplemental payments. These claims-based expenditures were divided 42% for persons with Medicare coverage (but not Medicaid), 29% for persons with Medicaid coverage (and not Medicare), and 29% for Medicaid/Medicare dual eligibles. Together, Medicaid and Medicare represented 5.6% of Gross Domestic Product (GDP), $2,582 per resident, and $5,740 per working person above age 16, (excluding active duty military personnel).
- Keywords: Expenditures Medicaid Medicare
This month’s edition provides data on the costs of Medicaid-covered adults and a conceptual framework for estimating the Medicaid expansion population’s emerging PMPM costs.
- Keywords: Expansion Expenditures Medicaid
The April 2014 edition of our five slide series focuses on historical Medicaid expenditure growth. The size of annual Medicaid cost increases do not seem to be driven by fluctuations in the economy or by which party holds the presidency. However, a correlation exists between the degree to which state governments are collectively under Democrat political control and relatively high percentage increases in Medicaid program costs. On a PMPM basis, data indicate an annual average cost increase from 2003-2010 very close to 5.0% for each of three major eligibility groups – children, adults (non-disabled, non-duals), and blind disabled (non-duals).
- Keywords: Expenditures Medicaid
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 identifying how a given program can be modified to better yield an optimal setting for facilitating access to needed care, ensuring that the services rendered are as cost-effective as possible, and helping covered populations maintain and improve their health status over the course of their daily lives. The years ahead create exciting opportunities to widen and strengthen partnerships between state and federal governments and the MCO industry in the Medicaid and Medicare arena.
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.