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The Secretary of the Department of Health and Human Services must provide a single, standardized, simplified form for states to use to determine eligibility for the programs. [...] States are required to screen applicants for all health subsidy programs and enroll them in the appropriate program, in the process requiring a minimum of paper-based data directly from the potential beneficiary and coordi- nating seamlessly across the programs. [...] SPEAKERS Carol Steckel, Medicaid commissioner in Alabama and president of the National Association of Medicaid Directors, will describe the history and current functioning of Medicaid eligibilty and enroll- ment in Alabama and across the nation, commenting on the many current challenges and issues that states face as they move toward health reform implementation in January 2014. [...] Cindy Mann, depu- ty administrator of the Centers for Medicare & Medicaid Services and director for the Center for Medicaid, CHIP, Survey and Certi- fication, will comment on what has been learned in the last decade about CHIP and Medicaid outreach and enrollment, as well as the administration's vision for the future of enrollment processes under http://www.nhpf.org F O R U M S E S S I O N S E P T. [...] KEY QUESTIONS • What is the history of Medicaid enrollment processes? What are the essential components of eligibility and enrollment systems? How extensive are changes that states will be required to make to enroll the millions of people who will be newly eligible under the PPACA? • How greatly do states vary in terms of the design and operation of their eligibility and enrollment processes? Can.
By December 31, 2006, the Commission must make longer-term recommendations on the future of Medicaid that ensure the long-term sustainability of the program.4 These recommen- dations will presumably include options for modifying the Medicaid benefit standard and loosening the limitations on cost sharing. [...] THE NGA PROPOSAL As part of its mission to represent the interests of the states, the NGA has engaged in the Medicaid debate. [...] Citing the desire to increase Medicaid beneficiaries' account- ability for the cost and utilization of health care, the proposal recom- mends permitting states to impose cost sharing beyond nominal levels for beneficiaries with incomes above the federal poverty level and to make cost-sharing requirements "enforceable."6 Using SCHIP as a model, the NGA proposal suggests a 5 percent cap on the total. [...] These variations from the Medicaid standards acknowledged, in part, the higher incomes of the families that would be the target of the new program (those with incomes up to 200 percent of the FPL). [...] The session will provide insights into the potential implications of these changes for beneficiaries, states, and the federal government in hopes of informing the debate that is under way in the Congress and within the Medicaid Commission.
Medicare and Medicaid Demonstrations: Experimenting for the Future oVerVieW Demonstrations have been a critical part of the evolution of the Medicare and Medicaid programs. [...] for more information - See Background Papers, "The Fundamentals of Medicare Demonstrations"and "Shaping Medicaid and SCHIP Through Waivers: The Fundamentals." See also two Basics publications on the same topics, "The Basics: Medicare Demonstrations" and "The Basics: Medicaid and SCHIP Waivers." SeSSion Medicare and Medicaid policy and operations have been informed and shaped by the hundreds of dem. [...] This Forum session will offer a range of perspectives on the history and policy context of Medicare and Medicaid demonstrations and waivers, and the role of these demonstrations now and in the future. [...] Kuhn is the acting deputy administrator of the Centers for Medicare & Medicaid Services (CMS) and is also currently the acting director of the Center for Medicaid and State Operations within CMS. [...] Ebeler has been a senior vice president and director of the health care group at the Robert Wood Johnson Foundation and was deputy assistant secretary for planning and evaluation for health and acting assistant secretary for plan- ning and evaluation at the U.
Forum Session Announcement - Medicaid Managed Long-Term Services and Supports (MMLTSS): Lessons from Three States F O R U M S E S S I O N Medicaid Managed Long-Term Services and Supports (MMLTSS): Lessons from Three StatesOCTOBER 5, 2012 The uptick in state interest in Medicaid managed long-term ser- vices and supports (MMLTSS) has drawn attention from national organizations and consumer advocacy. [...] A recent report for the Centers for Medicare & Med- icaid Services (CMS) indicates that current state planning initia- tives will result in 26 states having MMLTSS programs by 2014, up from 8 states in 2004 and from 16 states in 2012.1 In May 2012, the Forum held a meeting on MMLTSS that pro- vided an overview and discussion about evidence of its effect on cost savings and quality outcomes, action. [...] Arizona is a veteran of MMLTSS and began operation of the Arizona Long-Term Care System (ALTCS) in 1988. [...] Texas also has had a long-standing program, Star+Plus, that began in 1998 and operates in part of the state. [...] Betlach, director of the Arizona Health Care Cost Containment Sys- tem (AHCCCS); Erica Stick, special advisor, Office of the Executive http://www.nhpf.org http://www.nhpf.org MMLTSS: Lessons from Three Stateswww.nhpf.org 3 Commissioner, Texas Health and Human Services Commission; and Rosanne Mahaney, director, Division of Medicaid & Medical Assis- tance, Delaware Health and Social Services-discuss.
OvervIew With the ever-growing concern about costs in Medicaid and across the health care sector, many state officials and others aim to find savings and deliver more efficient and effective care. [...] What has been the experience among the states with serving this group of vulnerable people through managed care? In what ways are different states approaching this issue? This Forum session will review these questions and address the chal- lenges facing the nation and states in providing efficient and accessible medical care to persons with disabilities through Medicaid managed care arrangements. [...] For example, the estimated average spending on a person eli- gible for Medicaid on the basis of disability status was about $16,600 in fiscal year (FY) 2009, compared with average spending of $2,900 on non-disabled children, and $4,100 on adults without disabilities un- der 65 years of age.1 Expenditures for persons with disabilities under age 65 are the fastest growing segment of Medicaid costs.2. [...] The increasing number of people with chronic conditions and the amount of care needed grows each year; for exam- ple, people with five or more chronic conditions see about 14 physi- cians per year.3 Even if persons with disabilities have a stable chronic condition, they may be more at risk of infection, falls, and other com- plications and difficulties. [...] Speakers will review the background and history of coverage through managed care, studies that have evaluated states' experi- ences with managed care for persons with disabilities, the different types of managed care used by states, and the problems encountered in delivering care in this way.
The President has proposed spending reductions, congressional committees are holding hearings, the Secretary of the Department of Health and Human Services has chartered a reform commission, and the nation's governors have issued a new policy outlining their priorities for Medicaid reform. [...] There are more than 20 federal definitions of disability for deter- mining program eligibility and for use in statistical analysis.4 Thus, projecting the number of people with disabilities and the severity of their condition varies widely depending on the definition used. [...] The speakers will describe the Medicaid beneficiaries who have physical and cognitive impairments, including a discussion of their health needs, the services they receive, and the systems that deliver their care. [...] Throughout the briefing, opportunities to en- hance the understanding of the disabled population and improve the delivery of services will be noted. [...] Tritz worked at the Centers for Medicare & Medicaid and the Wisconsin Department of Health and Family Services, where she developed programs and policies in Medicaid long-term care and return-to-work efforts for adults with disabilities.
Forum Session Announcement - Targeting High-Cost Medicare Beneficiaries to Improve Care and Reduce Spending: Finding the Bull's-Eye F O R U M S E S S I O N Targeting High-Cost Medicare Beneficiaries to Improve Care and Reduce Spending: Finding the Bull's-EyeMARCH 9, 2012 In 2011, Medicare spent approximately $560 billion to provide health insurance coverage to 49 million elderly and disabled benef. [...] The Patient Protection and Af- fordable Care Act (PPACA), for example, created a new Center for Medicare and Medicaid Innovation (CMMI) at the Centers for Medicare & Medicaid Services (CMS) and provided $10 billion in funding over nine years to conduct an array of demonstrations whose goals are to reduce costs and improve care for Medicare and Medicaid beneficiaries. [...] In the Demonstration of Care Management for High-Cost Beneficiaries, the programs were not allowed to keep the entire fee unless they reduced Medicare spending for their beneficiaries by at least 5 percent, net of the fee. [...] This Forum session described the characteristics and spending pat- terns of high-cost Medicare beneficiaries, examined the track record of targeting within Medicare demonstrations and pilots, and pro- filed the experience of one health system's efforts to target and man- age high-cost Medicare beneficiaries. [...] Randall Brown, PhD, a vice president at Mathematic Policy Research, Inc., and director of health research for the New Jersey office, has participat- ed in the evaluation of several demonstrations/pilots at the Centers for Medicare & Medicaid Services.
Some of these individuals were subsequently http://www.nhpf.org http://www.nhpf.org Spending Trends in Private Insurance and Medicarewww.nhpf.org 3 covered by Medicaid, but the surge in Medicaid enrollment was already under way prior to the start of the recession, as some states expanded coverage to in- clude non-categorically eligible groups of the uninsured. [...] The most frequently cited reasons include: new technologies; the aging of the population; the rise in chronic conditions which require ongoing medical treatment; the propensity of wealthier individ- uals and communities to devote more of their resources to health care; inefficiency; misaligned payment incen- tives that reward increases in the volume and intensity 2006 2010 Average Annual Growth Ra. [...] It is almost always the largest single payer in a market due to the numbers of its beneficiaries and the much higher-than-average health care needs of those beneficiaries. [...] This Forum session provided an overview of spending trends in the private sector and in Medicare, teased apart some of the factors that contribute to spending growth for each payer, and explored some of the opportunities and challenges associated with taming costs for both Medicare and private payers. [...] Barone Professor of Economics and Health Policy at Carnegie Mellon University, Heinz College, and chair of the Governing Board of the Health Care Cost Institute, provided an overview of national trends in health care utilization and spending among those under age 65 covered by employer-sponsored, private health insurance.