Medicaid

• Medicaid managed care financial results for 2017

  By Jeremy D. Palmer, Christopher T. Pettit, Ian M. McCulla | 04 June 2018

  This report summarizes the calendar year 2017 experience for selected financial metrics of organizations reporting Medicaid experience under the Title XIX Medicaid line of business on the National Association of Insurance Commissioners annual statement.

• Medicaid buy-in: Section 1332 Innovation Waivers, state options, and top ten considerations

  By Paul R. Houchens, Christine M. Mytelka, Susan Philip | 11 May 2018

  Medicaid buy-ins are currently getting states’ attention.

• How changing opioid prescribing patterns can impact risk scores

  By Christine M. Mytelka, Melanie K. Kuester, Colin R. Gray, Lucas Everheart | 19 April 2018

  This brief provides data on the decline in opioids prescribed to Medicaid expansion populations and the increased use of other non-opioid pain relief drugs.

• Enabling sustainable investment in social interventions: A review of Medicaid managed care rate-setting tools

  By Deborah Bachrach, Jocelyn Guyer, Sarah Meier, John D. Meerschaert, Shelly S. Brandel | 06 February 2018

  This report identifies practical strategies that states can deploy to support Medicaid managed care plans and their network providers in addressing social issues.

• Risk adjustment in CMS episode-based payment models: A resource guide

  By Samuel Bennett, Thomas D. Snook | 20 December 2017

  This paper provides a high-level guide on risk adjustment within the broader scope of four Centers for Medicare and Medicaid Services episode-based payment models.

• Telehealth under alternative payment models

  By Susan Philip | 13 September 2017

  Telehealth has the potential to boost the impact of population health management initiatives while improving access and convenience of healthcare delivery.

• Medicaid risk-based managed care: Analysis of financial results for 2016

  By Jeremy D. Palmer, Christopher T. Pettit | 07 July 2017

  This report summarizes the calendar year 2016 experience for selected financial metrics of organizations reporting Medicaid experience under the Title XIX Medicaid line of business on the National Association of Insurance Commissioners annual statement.

• Medicaid risk-based managed care: Analysis of administrative costs for 2016

  By Jeremy D. Palmer, Christopher T. Pettit, Ian M. McCulla | 07 July 2017

  This report summarizes the calendar year 2016 experience for selected administrative metrics of organizations reporting Medicaid experience under the Title XIX Medicaid line of business on the National Association of Insurance Commissioners annual statement.

• The American Health Care Act

  By Jason Karcher | 09 May 2017

  This paper explores the impacts of the May 4, 2017, version of the American Health Care Act as passed by the House on different markets and stakeholders of the healthcare system.

• Actuarial soundness under Medicaid block grants and per capita caps

  By Michael C. Cook | 10 March 2017

  Actuarially sound capitation rates will remain critical to the long-term viability of Medicaid managed care programs.

See More Articles