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Advocates ask CMS for Improvements in Demonstrations to Integrate Care for Dually Eligible Beneficiaries

AUCD joins 34 other organizations in letter

In this letter to Melanie Bella, Director of the Medicare-Medicaid Coordination Office, disability and aging advocates urge for increased transparency, quality measures, readiness review, and continuity of care in demonstrations to integrate care and align financing for those dually eligible for both Medicare and Medicaid.

pdf File Dual Eligible stakeholder letter June 19 2013.pdf [download]


CBO Releases New Report on Dual-Eligible Beneficiaries of Medicare and Medicaid

This report examines the characteristics and costs of dual-eligible beneficiaries, focusing on 2009, the most recent year for which comprehensive data were available when CBO began this analysis. The report also examines the different payment systems that Medicare and Medicaid use to fund care for dual-eligible beneficiaries and recent efforts at the federal and state levels to integrate those payment systems and to coordinate the care that such beneficiaries receive from the two programs.



FMC Balancing Incentive Program Webinar Recording Available

On May 30, the Friday Morning Collaborative (FMC), which is a coalition of national aging and disability organizations that work to advance long-term services and supports for older adults and individuals with disabilities, held a webinar called "Balancing Incentive Program: Highlighting State Approaches and Progress."



Primary Care: Our First Line of Defense

This brief from the Commonwealth Fund's "Health Reform and You" series, explains why primary care is so important to patients and to the country's bottom line.



Report: Consumers Will Have More Options in State Exchanges

A new analysis shows the number of insurers that offer nongroup plans to consumers on state-run health insurance exchanges will be larger than the current number of carriers. RWJF's State Health Reform Assistance Network compared insurers offering plans prior to national health reform with insurers applying to offer plans on state exchanges. Across all 10 states that have released data, the number of insurers offering non-group plans will increase 35 percent, from 52 to 70 plans.



State-Level Progress in Implementation of Federally Facilitated Exchanges

Findings in Three Case Study States

Health insurance exchanges are one cornerstone of the Affordable Care Act, offering structure and organization to the small group and non-group health insurance markets. A new report from the Urban Institute highlights three case studies of states opting for Federally Facilitated Exchanges and the roles they are playing in the implementation process and will play once the exchange is operational.



To Expand or Not to Expand? States' Medicaid Dilemma

In 2014, many states will expand Medicaid to cover their poor and near-poor residents, but others will not. As the undecided states make up their minds, a new report shows that, in 10 diverse states, very different approaches were taken to analyze impacts. Those states that conducted comprehensive analyses found that Medicaid expansion will see: (a) net state budget gains and (b) increased employment and tax revenues.



Enroll America State Exchange Profiles

Enroll America, a national nonprofit whose mission is to maximize the number of Americans who enroll in coverage made available by the ACA, has created this resource on Exchanges. Click on your state to learn about your state's Exchange, website, outreach and education efforts, and additional resources.



Trust for America's Health Report on the Prevention and Public Health Fund

The Truth About the Fund

The Affordable Care Act (ACA), for the first time in the nation's history, created a dedicated fund for prevention. Learn what the fund has accomplished so far with this tool from Trust for America's Health.



Coordinating Human Services Programs with Health Reform Implementation

A Toolkit for State Agencies

Originally published in 2011, this toolkit from the Center on Budget and Policy Priorities continues to be useful as states implement the Affordable Care Act this year and in the years to come. The toolkit will help states consider new Medicaid participants' connection to other benefits as part of health reform implementation.



Enrollment and Outreach: KFF Applies Lessons Learned from Medicaid/CHIP to ACA Implementation

The Affordable Care Act (ACA) will significantly increase coverage options through an expansion of Medicaid and the creation of new health insurance exchange marketplaces. However, effective outreach and enrollment efforts will be key to ensuring these new coverage opportunities translate into increased coverage. Based on a review of existing research, this brief identifies five key lessons learned through previous Medicaid and CHIP experience to help inform outreach and enrollment under the ACA.



Premium Assistance in Medicaid

Health Policy Brief from Health Affairs and RWJF

Nearly a year after the US Supreme Court's June 2012 decision declaring the ACA's Medicaid expansion optional, states continue to grapple with whether or not to pursue the option for newly eligible populations. Although the Medicaid expansion accounted for about half the total number of people projected to gain coverage under the ACA, many states to date have declined to expand Medicaid or are leaning toward rejecting the option because of cost and political concerns. Recently, states have begun to consider a "private option" - expanding Medicaid by offering premium assistance to newly eligible beneficiaries through the Exchange. This brief examines the viability of the option.



Health Insurance Subsidy Calculator

Website  from

This tool illustrates health insurance premiums and subsidies for people purchasing insurance on their own in new health insurance exchanges (or "Marketplaces") created by the Affordable Care Act (ACA). Beginning in October 2013, middle-income people under age 65, who are not eligible for coverage through their employer, Medicaid, or Medicare, can apply for tax credit subsidies available through state-based exchanges. With this calculator, you can enter different income levels, ages, and family sizes to get an estimate of your eligibility for subsidies and how much you could spend on health insurance. As premiums and eligibility requirements may vary, contact your state's Medicaid office or exchange with enrollment questions.



Kaiser Family Foundation Compares Financial Alignment Demonstrations for Dual Eligible Beneficiaries in California, Illinois, Massachusetts, Ohio, and Washington

This policy brief compares demonstration programs in California, Illinois, Massachusetts, Ohio, and Washington state that will introduce changes in the care delivery systems through which people who are dually eligible for Medicare and Medicaid receive services, as well as changing the payment approach and financing arrangements among the Centers for Medicare and Medicaid Services, the states and providers.



A Communications Work Plan to Engage Stakeholders in Medicaid Managed Long-Term Services and Supports Program Development

State Medicaid programs are increasingly exploring ways to provide long-term services and supports (LTSS) through capitated managed care plans rather than traditional fee-for-service delivery systems. Stakeholder engagement is crucial to the proper implementation and operation of MLTSS. The Center for Health Care Strategies has created this work plan to provide states with practical strategies to facilitate stakeholder engagement throughout the design and implementation of a Medicaid MLTSS program.

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