Medicaid Expansions

High-performing health plans are critical to the success of efforts to align Medicare and Medicaid services, including the capitated financial alignment demonstrations as well as Dual Eligible Special Needs Plans. Yet, there is little consensus about what makes an integrated health plan high-performing. This brief introduces a framework of key attributes of high-performing health plans. While the framework is intended as a guide rather than a set of formal criteria, it can help states and health plans establish the elements essential to successfully providing coordinated, person-centered, integrated care that meets the needs of individuals with complex needs.
 

Medicaid is the largest health insurance program in the United States, covering both acute and long-term care services for over 66 million low-income Americans—children and their parents, as well as elderly and disabled individuals. This report focuses on the impact of Medicaid on the states, including trends in spending and enrollment, and the anticipated effects of the ACA.
 

Fast-track enrollment strategies do more than help people sign up for Medicaid—they save states money. These strategies speed up the eligibility process by allowing states to use information they already have on file from other public benefit programs. By vastly reducing the time eligibility workers spend processing Medicaid applications, fast-track strategies can reduce administrative expenses. This brief examines the costs and savings of two states—West Virginia and Illinois—implementing fast-track enrollment in Medicaid.

The Centers for Medicare and Medicaid Services recently released information on how many additional people were enrolled in coverage through Medicaid and CHIP since October 1, 2013, when the first open-enrollment period for the new health insurance marketplaces was launched, through April 2014, the most recent information available. This brief assesses how reported changes in enrollment in Medicaid and CHIP during this period compare with changes in Medicaid/CHIP enrollment projected by the end of 2016 by the Urban Institute’s Health Insurance Policy Simulation Model (HIPSM).
 

Many states are incorporating policies into their Medicaid programs that seek to enhance beneficiaries’ ability to make informed decisions about their health and health care and become more active, engaged participants in the health care system. Several of these consumer incentive programs are tied to a broader state effort to use federal funds to extend coverage to a previously uninsured population. This technical assistance tool provides examples of consumer incentives and personal responsibility in Medicaid programs across the nation, including strategies used in new alternative expansion models.