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Impact of Federal Medicaid Policy on State Delivery Reform

Medicaid managed care regulations
Achieving Universal Coverage

Proposed Revisions to Medicaid Managed Care Leave Framework in Place But Weaken Requirements on Access to Care

Regulations in place since 2016 that allowed state Medicaid programs flexibility to use managed care contracting and payments to drive reform in how health care is delivered and paid for are likely to remain largely intact. However, certain provisions will weaken standards designed to ensure a sufficient network of health providers is available to serve enrollees.

Blog / Jan 04, 2019

Patient who doesn't know about Medicaid Work Requirements
Advancing Health Equity

Are New Medicaid Waivers on a Collision Course with State Delivery System Reform?

While new Medicaid waiver policies, such as work requirements, have been fervently debated, relatively little attention has been paid to how these policies might affect state delivery system reform efforts aimed at improving health and bending the cost curve. The court decision invalidating Kentucky’s work requirements — and the Centers for Medicare and Medicaid Services’ decision to reopen the comment period on the Kentucky demonstration — offers an opportunity to think about the intersections of waivers and delivery system reform.

Blog / Sep 26, 2018

Opioid epidemic long road ahead
Achieving Universal Coverage

Medicaid Provisions in the SUPPORT Act: An Important Step Forward in the Opioid Epidemic, but the Road Ahead Is Long

There are still gaps in Medicaid coverage of substance use disorder treatment. Fifteen states do not yet cover all three forms of medication-assisted treatment. Moreover, states have historically been precluded under federal law from using federal Medicaid funds to provide care to beneficiaries between ages 21 and 64 residing in Institutions for Mental Disease (IMDs), which are hospitals or residential facilities that care for people with mental illnesses or substance use disorders. The SUPPORT Act takes some important steps to address these issues.

Blog / Nov 13, 2018

Immigrant child receives health care under Medicaid coverage
Controlling Health Care Costs

Public Charge Rule Would Have Significant, Negative Impact on Immigrants’ Health Care and the Safety-Net Delivery System

By disrupting coverage for so many people, the "public charge" rule also will have a significant impact on the delivery system, reducing Medicaid support for health care providers and driving up uncompensated care. Safety-net providers and health care providers in communities with large immigrant populations will be particularly hard-hit, affecting not only their fiscal health but their ability to serve the broader community.

Blog / Nov 20, 2018