Medicaid Long Term Services and Supports Annual Expenditures Report: Federal Fiscal Year 2019

This report presents Medicaid long term services and supports (LTSS) expenditures for fiscal year 2019.

Advancing Integrated Care for Dually Eligible Individuals: Factors Influencing State D-SNP Contracting Decisions

With support from MACPAC, Mathematica studied state D-SNP contracting strategies aimed at integrating Medicare and Medicaid. A report and issue brief summarize key findings, including the importance of state context and resources; challenges in rural areas; and considering potential trade-offs and unintended...

Medicare Advantage Star Ratings

David Meyers and colleagues (Feb 2021) examine the effects of Medicare Advantage (MA) star ratings on patient outcomes by studying what happens when enrollees are shifted to higher-rated plans via contract consolidation.

Why Dually Eligible Beneficiaries Stay or Leave Integrated Care Plans

This study examined factors affecting voluntary disenrollment by beneficiaries enrolled in Medicare Advantage Dual Eligible Special Needs Plans, focusing on quality and member experience scores, Medicaid integration level, state Medicaid policies, and local market dynamics.

Medicaid Long-Term Services and Supports Annual Expenditures Report: Federal Fiscal Years 2017 and 2018

This report presents Medicaid long-term services and supports (LTSS) expenditures for fiscal years 2017 and 2018.

Medicaid Managed Long-Term Services and Supports: Summative Evaluation Report

This report presents findings from a multi-state evaluation examining how managed long-term services and supports (MLTSS) beneficiaries compare to those receiving long-term services and supports (LTSS) in fee-for-service (FFS) on spending, service use, quality of care, access to care, and beneficiary...

A Study of the COVID-19 Outbreak and Response in Connecticut Long-Term Care Facilities: Final Report

This report details Mathematica’s assessment of the COVID-19 outbreak in Connecticut long-term care facilities, as well as a set of short-term and long-term recommendations to help Connecticut and long-term care facilities prepare for a potential second wave of COVID-19 and prevent future infectious...

A Study of the COVID-19 Outbreak and Response in Connecticut Long-Term Care Facilities: Interim Report

This report details Mathematica’s preliminary assessment of the COVID-19 outbreak in Connecticut long-term care facilities, as well as a set of short-term recommendations to help Connecticut and long-term care facilities prepare for a potential second wave of COVID-19.

Enticing Dually Eligible Beneficiaries to Enroll in Integrated Care Plans

Mathematica researchers conducted a study to determine what factors were associated with state variation in participation rates in the Centers for Medicare and Medicaid Services’ Financial Alignment Initiative (FAI) that offered beneficiaries eligible for both Medicare and Medicaid enrollment in integrated...

The Complex Art of Making It Simple: Factors Affecting Enrollment in Integrated Care Demonstrations for Dually Eligible Beneficiaries, Appendices

This study used both quantitative and qualitative data analysis to identify factors associated with enrollment in 11 Financial Alignment Demonstrations in 10 states. These Demonstrations provide integrated care for dually eligible beneficiaries through Medicare-Medicaid Plans (MMPs).

The Complex Art of Making It Simple: Factors Affecting Enrollment in Integrated Care Demonstrations for Dually Eligible Beneficiaries

This study used both quantitative and qualitative data analysis to identify factors associated with enrollment in 11 Financial Alignment Demonstrations in 10 states. These Demonstrations provide integrated care for dually eligible beneficiaries through Medicare-Medicaid Plans (MMPs).

Medicaid Managed Care Enrollment and Program Characteristics, 2016

The data and information presented in this report were collected directly from all states, the District of Columbia, and US territories.

Examining New York’s Delivery System Reform Incentive Payment Demonstration: Achievements at the Demonstration’s Midpoint and Lessons for Other States

New York’s Delivery System Reform Incentive Payment demonstration, authorized by a Medicaid section 1115 waiver, is an ambitious and complex effort to transform the health care delivery system, reduce cost growth, and improve care outcomes for Medicaid beneficiaries and uninsured individuals.

Managed Long-Term Services and Supports: Interim Evaluation Report

This interim evaluation examines how utilization of specific services by MLTSS enrollees compares to that of fee for service (FFS) beneficiaries using LTSS.

Designing Medicaid Delivery System Reform Incentive Payment Demonstrations to Reward Better Performance

This brief describes differences in incentive design features of six DSRIP demonstrations and assesses their strengths and limitations in promoting provider participation in delivery system reform and value-based payment (VBP) arrangements.

HCBS Claims Analysis Chartbook: Final Report

This MACPAC-commissioned report describes the characteristics and service use of Medicaid enrollees who used HCBS, and analyzes Medicaid spending for these HCBS users, by state and over time.

Value-Based Payment in Nursing Facilities: Options and Lessons for States and Managed Care Plans

To improve the value of care provided in nursing facilities, payers are experimenting with value-based payment (VBP) approaches that link financial rewards to measures of quality.

Who Enrolls in Medicaid Managed Care Programs that Cover Long-Term Services and Supports? Implications of Enrollee Diversity for a National Cross-State Evaluation

This issue brief supports the national evaluation of Medicaid Section 1115 demonstrations by describing the diversity of the beneficiary groups enrolled in 35 MLTSS programs operating in 23 states as of July 2016.

Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability

In a project for the Centers for Medicare & Medicaid Services Center for Medicaid and CHIP Services, Mathematica developed a toolkit to assist states in developing their network adequacy and service availability standards for Medicaid and CHIP managed care organizations (MCOs).

On the Road to Universal Children's Coverage: A Final Update on the KidsWell Campaign (Issue Brief)

The primary goal of the KidsWell Campaign was to ensure access to health insurance for all children, which in turn was expected to lead to improved health outcomes.

Supporting Advocacy to Achieve Universal Children's Health Coverage: Final Report on the KidsWell Campaign

When the Patient Protection and Affordable Care Act (ACA) passed in 2010, about 6.2 million children were uninsured; of those, nearly 70 percent were already eligible for coverage through Medicaid or the Children’s Health Insurance Program (CHIP) but not enrolled (Kenney et al. 2012).

Look Before You Leap: Risk Adjustment for Managed Care Plans Covering Long-Term Services and Supports

This brief reviews risk-adjustment strategies in Medicaid managed long-term services and supports programs that account for enrollees’ functional and cognitive status to improve the accuracy of capitation rates, as well as technical challenges and state program features that may affect the need to use...

Population Diversity in Medicaid Managed Long-Term Services and Supports Programs: Implications for Rate Setting and Risk Adjustment

This brief discusses how states can use information on demographic and functional limitations to predict the cost of care for people with disabilities through risk adjustment and identifies variables that can affect the predictability of Long-Term Services and Supports needs and costs that may not be...

Medicaid Managed Long-Term Services and Supports: Themes from Site Visits to Five States

To understand the growth and diversity of Medicaid managed long-term services and supports (MLTSS) programs, we visited five states in Summer 2014: Arizona, Florida, Illinois, New York, and Wisconsin. This paper presents themes related to design, implementation, oversight, and improvement of MLTSS.

Developing Capitation Rates for Medicaid Managed Long-Term Services and Supports Programs: State Considerations

This brief identifies themes from the experiences of states at the forefront of Medicaid managed long-term services and supports that other states may want to consider as they seek to improve rate-setting and risk-adjustment methods, including efforts that promote services in home- and community-based...

Medicaid Managed Care Enrollment and Program Characteristics, 2015

The data and information presented in this report were collected directly from all states, the District of Columbia, and US territories.

Family Caregiving: 20 Years of Federal Policy (In Focus Brief)

Family caregivers are a hidden workforce that is essential to meet the growing demand for long-term services and supports by older adults and people with disabilities.

Hand in Hand: Enhancing the Synergy between Money Follows the Person and Managed Long-Term Services and Supports

In this report, we describe the interaction between Money Follows the Person and Managed Long-Term Services and Supports in seven states: Hawaii, Massachusetts, Minnesota, New Jersey, Tennessee, Texas, and Wisconsin.

Competitive Grant-Making: Lessons for Funders to Help Local Governments Increase Health Coverage

The Atlantic Philanthropies contracted with Mathematica to explore the advantages and disadvantages of competitive grant-making to achieve foundations’ grant-making objectives.

Medicaid 1115 Demonstration Evaluation Design Plan

This report lays out the general design and approach Mathematica will use to evaluate four types of Medicaid section 1115 demonstration waivers: (1) Delivery System Reform Incentive Payments (DSRIP), (2) Premium Assistance Medicaid expansions, (3) Beneficiary Engagement/Premium Payment demonstrations,...

On the Road to Universal Children's Health Coverage: An Interim Report on the KidsWell Campaign

Recognizing the Affordable Care Act as a crucial opportunity to close the children’s insurance coverage gap, the Atlantic Philanthropies created the KidsWell Campaign to try to achieve universal children’s health care coverage and support an enduring infrastructure that would remain after Atlantic’s...

On the Road to Universal Children's Health Coverage: An Update on the KidsWell Campaign

Recognizing the Affordable Care Act as a crucial opportunity to close the children’s insurance coverage gap, the Atlantic Philanthropies created the KidsWell Campaign to try to achieve universal children’s health care coverage and support an enduring infrastructure that would remain after Atlantic’s...

Competitive Grant-Making: A Review of the Literature

As part of the evaluation of the Cities Expanding Health Access for Children and Families program for Atlantic Philanthropies, Mathematica conducted a targeted literature review of scholarly and other published sources to identify previous publications regarding competitive grant-making strategies.

Measuring Up: A Novel Approach to Assessing State Oversight of Medicaid Managed Care

This brief describes a novel approach that Mathematica Policy Research used to evaluate state oversight of a new Medicaid managed care program for individuals people with disabilities in Washington State.

Securing Coverage for Children by Advocating for the ACA: Experience from the KidsWell Grantees in New Mexico and New York

The expansion of Medicaid eligibility to low income adults and subsidies to purchase private insurance are arguably the most significant provisions of the Affordable Care Act (ACA).

Toward a More Perfect Union: Creating Synergy Between the Money Follows the Person and Managed Long-Term Services and Supports Programs

This report examines how five states have structured the interface between Money Follows the Person (MFP) demonstration grants and Managed Long-Term Services and Support (MLTSS) programs to promote transitions from institutional care to home- and community-based settings.

Keeping Watch: Building State Capacity to Oversee Medicaid Managed Long Term Supports and Services (Presentation)

Growing numbers of state Medicaid agencies are developing or expanding risk-based managed care programs that cover long-term services and supports for older adults and people with disabilities, individuals with costly and complex health care needs.

Keeping Watch: Building State Capacity to Oversee Medicaid Managed Long-Term Services and Supports

Growing numbers of state Medicaid agencies are developing or expanding risk-based managed care programs that cover long-term services and supports for older adults and people with disabilities, individuals with costly and complex health care needs.

Organizing Care for Complex Patients in the Patient-Centered Medical Home (Journal Article)

This article summarizes strategies to help smaller primary care practices transform into medical homes that effectively serve patients with complex needs, particularly the frail elderly and working-age adults with disabilities.

Leading the Way: Maine's Initial Experience in Expanding Coverage Through Dirigo Health Reforms

Since enacting comprehensive health care reform in 2003, Maine's Dirigo Health program has helped expand coverage for low- and moderate-income individuals.