Sourcebook

Chapter 3 – Medicaid and CHIP

State-federal partnerships that provide health coverage for people with low incomes, children, pregnant women, parents of dependent children and disabled individuals.

Assessing Innovations in Medicaid

Medicaid is testing numerous new alternative payment and delivery system models to enhance the coordination of the health care services provided to millions of low-income Americans. This briefing examined the range of Medicaid’s efforts to improve care and promote value, including integrating health with non-clinical and behavioral services, creating managed care organizations, and instituting regional care collaborative organizations. Our panel also addressed Medicaid’s role in managing emerging issues such as the opioid epidemic and the spread of the Zika virus.






High-Need, High-Cost Patients: Challenges & Promising Models

Health systems have applied many innovative new strategies for improving quality and reducing costs when it comes to care for high-need, high-cost patients, who typically have multiple chronic conditions. Which of these innovations show promise, and what can we learn from them?






Briefing for Reporters on State Health Initiatives

A governor met with reporters Friday, February 19 to discuss the latest health care innovations and changes they are pursuing or implementing. Gov. Asa Hutchinson, R-Ark., discussed his experience with the state’s program to move newly eligible Medicaid beneficiaries to qualified health plans, and his intentions for changes moving forward.






Health Care Out from Behind Bars: Meeting Reentering Prisoners’ Needs Efficiently

Research shows that approximately 40 percent of former federal prisoners and over 60 percent of former state prisoners are rearrested within three years of release and many are re-incarcerated. Individuals transitioning into and out of the criminal justice system include many low-income adults with significant physical and mental health needs. Through outreach and education, correctional facilities are increasingly playing a key role in connecting eligible individuals to health care coverage and other social supports to facilitate their reintegration into the community. The Medicaid coverage expansion is also providing new opportunities to increase health care access to this particular population and potentially improving health outcomes, while bringing down costs. This briefing, the last in our “Medicaid: Beyond the Silos” series, built on last year’s correctional health briefing, with an added focus on reentry programs, and further explored the intersection of health policy and the criminal justice system.






Home and Community-Based Services: System-wide Coordination to Improve Care, Hold Down Costs

The movement toward home and community-based, long-term services and supports (LTSS) continues to grow, resulting in increased demand for these services. The goal is to help people live in the community independently, yet many barriers to offering HCBS still exist. This briefing will examine the potential of HCBS to reduce health care costs and improve quality of care. It will explore the intersection of HCBS, the broader health care delivery system and Medicaid, which is the largest payer of LTSS.






Long-Term Services and Supports Toolkit: Changes and Challenges in Financing and Delivery

The aging of the baby boomers and the increase in the number of old-old persons (those 85 and older) are predictors for the increasing need for long-term services and supports (LTSS). Among persons age 65 and over, an estimated 70 percent will use LTSS. A new Alliance for Health Reform toolkit, “Long-Term Services and Supports: Changes and Challenges in Financing and Delivery,” provides a background on LTSS and discusses policy issues surrounding the topic.

Medicaid 101: What You Need to Know

With some states grappling over whether to expand Medicaid, and Congress facing big decisions about the future of the Children’s Health Insurance Program (CHIP), this briefing reviewed the basics about both programs and discuss current issues.






Health Care Behind Bars: A Key to Population Health?

This briefing explored innovations and challenges in delivering health care to a growing population of inmates, and also the prospect of health care in the correctional setting as a key to improving population health. This is an expensive group because of the large number of people with mental illness, addiction disorders, conditions associated with aging and Hepatitis C. Indeed, corrections spending is the second fastest-growing state expenditure, behind Medicaid, according to the Pew Charitable Trusts.






Children’s Health Coverage: What You Need To Know

Approximately 8 million children with low to moderate incomes are covered under the Children’s Health Insurance Program (CHIP) and 39 million children are covered under Medicaid. (Most children who have coverage have private coverage). The number of uninsured children has decreased by half since the enactment of CHIP in 1997; however, with a new coverage landscape and CHIP funding set to expire in October 2015, questions arise about the current state and future of children’s health care coverage.






State Medicaid Expansion: The Third Way

To date, about half of states have moved forward with the Affordable Care Act’s optional Medicaid expansion. Now, additional states are pursuing an altogether different path that would allow them to use federal Medicaid funds to help low-income residents buy private coverage. Arkansas, Michigan and Iowa have already received federal Medicaid waivers and launched programs. Others are in various stages of drafting and negotiating. A few are considering block grants.






State Health Law Implementation: Race to the Starting Line – Philadelphia

The Philadelphia chapter of the Association of Health Care Journalists and the Alliance for Health Reform on Tuesday, June 18 held a special event to explore the challenges that Pennsylvania and New Jersey face this year leading up to the 2014 health law changes. This year the giant health law begins to move into its most climactic phase. Tens of millions of people are about to get health insurance, and this meeting will help reporters understand the epic challenges ahead.






Medicare-Medicaid Coordination for Dual Eligibles: What’s it All About?

Over nine million Americans receive benefits from both Medicare and Medicaid costing over $315 billion in health care services in the two programs combined. The dual eligibles account for 15 percent of the Medicaid population and almost 40 percent of all Medicaid expenditures for medical services; and 20 percent of the enrollees in Medicare, but 30 percent of the expenditures.






ACA 101: What You Need to Know

An April 26 briefing, ACA 101: What You Need to Know, was intended to be especially helpful to congressional staff members and others with limited knowledge of the Patient Protection and Affordable Care Act (ACA), but also to be a useful review for anyone dealing with the complex issues leading up to major changes scheduled to take effect in 2014.






Medicaid 101: What You Need to Know

A March 1 briefing, Medicaid 101: What You Need to Know, was especially helpful to congressional staff members and others new to the issue, but it was also a useful review for anyone dealing with Medicaid issues, particularly as many states prepare to expand their programs.






Medicaid Expansion Briefing: What’s at Stake for States?

Following the Supreme Court’s decision this summer on the Patient Protection and Affordable Care Act, the nation’s governors and state leaders face the choice to participate or opt out of the Medicaid expansion. Currently, twelve states have decided to participate in the expansion, seven states have decided to opt out, and the remaining states have yet to announce their participation status. As state officials move forward with selecting an approach, a November 30 briefing examined the economic impact of expanding Medicaid to 138 percent of the federal poverty level.