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November 20, 2014
Lessons from CA: Marketplace Renewals
dfitzgerald Issue Brief
In this month's Lessons from California, we review the annual renewal process for Covered California's (California's state marketplace) enrollees and where it differs from the renewal process in the federally facilitated marketplace (FFM). As this is the first renewal period for all marketplaces, best practices will become clearer for…
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November 4, 2014
Due Process in Duals Demonstrations: A Closer Look at New York
dfitzgerald Issue Brief
New York is one of several states working to better integrate care and services for individuals dually eligible for Medicare and Medicaid through a duals demonstration. In addition to integrating care, New York is working to integrate the Medicare and Medicaid appeals processes for individuals participating in its duals…
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October 30, 2014
Medicaid and Medicare: Aging, Access and Affordability
David Machledt Issue Brief
Affordability is a cornerstone of any efficient and effective health care system. Discussions of healthcare affordability often center on the premiums - the upfront monthly cost of purchasing insurance. But equally important are the back-end deductibles, copays and coinsurance associated with actually accessing services. Cost sharing is especially important…
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October 29, 2014
Lessons from CA: Covering Behavioral Health Treatment in Medi-Cal
dfitzgerald Issue Brief
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October 27, 2014
CMS’s guidance on EPSDT Services for Children with ASD
dfitzgerald Issue Brief
In July, 2014, the Centers for Medicare and Medicaid Services (CMS) issued guidance clarifying that evidence-based treatments for children with autism spectrum disorders (ASD), including behavioral and communication approaches to treatment, are eligible for federal financial participation under three State Plan authorities. CMS explained that states are obligated to cover…
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October 27, 2014
Reducing Medicaid Emergency Department Use: Increase Accessibility, Not Copays
David Machledt Issue Brief
Emergency department care, one of the most frequently cited drivers of health care costs, has become a major target for cost sharing policies. The stereotypical "frequent flyer" who uses the emergency department (ED) for every cough and sniffle has become a powerful, but unwarranted symbol of inefficient spending driven…
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