More than two-thirds of payers have published a patient access point in compliance with the Final Interoperability and Patient Access Rule, according to a study from the Council for Affordable Quality...
Uninsured adults with moderate to severe symptoms of anxiety or depression were less likely to receive mental healthcare services compared to adults with healthcare coverage, according to a Kaiser...
CalOptima—a county-organized health system that offers care through public payer coverage, including Medicaid, Medicare Advantage, and Medicare-Medicaid plans—is launching a five-year...
States have four main tools at their disposal for managing risk in Medicaid managed care organizations, according to a MACPAC issue brief.
Medicaid managed care organizations are reimbursed in a...
As the public health emergency (PHE) nears an end, policymakers must consider expanding temporary public payer policies that improve person-centered care for beneficiaries, including telehealth and...
As the Affordable Care Act turns 12 years old, CMS and the Department of Health and Human Services (HHS) commemorate the law’s impact on the US healthcare system.
“On the...
With misinformation about the public charge rule still circulating and affecting immigrants’ access to coverage, Medicaid programs, Affordable Care Act marketplace plans, and CHIP programs can...
Pregnant people were more likely to experience high out-of-pocket healthcare spending, but Medicaid and public health insurance coverage helped minimize costs compared to private insurance, a study...
The end of the coronavirus public health emergency declaration could lead to a shift in Medicaid spending for state Medicaid programs and federal Medicaid costs, according to a report from the Robert...
Medicaid spending grew to $116 billion on home and community-based services (HCBS) during fiscal year 2020, providing services to 3 million people through waivers and more than 2.5 million people...
Transitioning Medicare-Medicaid plans into dual eligible special needs plans may pose challenges that the proposed rule for 2023 Medicare Advantage and Medicare Part D policy and technical changes...
Medicaid managed care enables care coordination, incorporation of social determinants of health into care, trust-building between healthcare stakeholders, stakeholder accountability, and flexibility...
With the understanding that the public health emergency will eventually come to an end, experts from Kaiser Family Foundation (KFF) are asking what will happen if the US does not have a plan in place...
Medicaid programs can use 1115 Medicaid demonstration waivers to expand health equity in four key ways, by expanding eligibility and benefits, filling gaps left by the Affordable Care Act,...
Medicaid fee-for-service beneficiaries who tried to quit smoking cigarettes rarely accessed cessation medication or counseling despite the wide range of cessation treatments that Medicaid covers, a...
State and Medicaid coverage for obesity treatments is not uniform, despite the epidemic-level impact of the condition and the selection of tested treatment options, according to a report from the Urban...
In states that have not adopted Medicaid expansion, individuals with HIV have limited access to care, but pending legislation and potential future expansions could change those circumstances, a Kaiser...
AHIP supported CMS on its national coverage determination for monoclonal antibodies (mAbs) directed against amyloid for treating Alzheimer’s Disease and offered recommendations for clarification...
Payers have a significant role to play in ensuring that underserved populations receive whole person care, particularly among Medicaid beneficiaries.
First, they can serve as a bridge between Medicaid beneficiaries and their primary care...
MACPAC has released data on utilization and healthcare spending trends among dual eligible beneficiaries in calendar year 2019.
First, the report assessed dual eligible use of certain Medicare...
