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Dual eligibles, individuals enrolled in both Medicare and Medicaid, are among the highest-need, highest cost patients in the United States. Although it is difficult to determine the exact number of dual eligibles, a 2012 Kaiser Family Foundation report estimates that dual eligibles comprise 21 percent of the Medicare population and 15 percent of the Medicaid […]
Introduction During the 1970s, in an effort to limit rising health care expenditures, several states adopted various forms of all-payer rate-setting models, where all payers pay the same price for services at a given facility. Over time, most state models failed and only Maryland’s all-payer hospital rate-setting system remains. Recently, there is renewed interest in […]
On April 26, 2016, CMS released final rules for Medicaid managed care and CHIP, marking the first revamp of these rules in over 10 years. Currently, 39 states and D.C. rely on managed care to provide services to all or a portion of their Medicaid beneficiaries, and that number is growing. The use of managed […]
This post is a four-part series on state health care innovation efforts. This post will give a broad overview of some of the opportunities available to states that support their efforts in transforming health care payment and delivery systems. Upcoming posts will discuss each of these opportunities in more detail. The Affordable Care Act (ACA) […]
This is the third post in a four-part series about state health care innovation efforts. This post discusses the State Innovation Models in more detail, and the last post will discuss Section 1332 waivers.
With an increased focus on health care and Medicaid expansion, states are looking for ways to increase the efficiency and quality of the program.
State health care innovation is accelerating, with many states developing initiatives to further their efforts to improve health care.