The National Medicaid Congress “Medicaid Managed Care: Opportunities and Implications of State Expansions” Brian Coyne Senior Vice President Federal Government.

Slides:

Advertisements

Similar presentations

The Affordable Care Act: Putting Reform into Medicaid and Medicaid into Reform Cindy Mann, JD CMS Deputy Administrator Director Center for Medicaid, CHIP.

Advertisements

MyCare Ohio (Integrated Care Delivery System) May 6, 2014 John Rogers Manager, Eligibility Services

Center on Budget and Policy Priorities cbpp.org Medicaid Expansion and State Budgets Progressive States Network Medicaid Expansion Webinar July 17, 2011.

PUBLIC SECTOR INITIATIVES TO CONTROL COSTS: MEDICAID Jim Verdier Mathematica Policy Research, Inc. Citizens’ Health Care Working Group Arlington, VA May.

DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 13 Sources of Long- Term Care Spending Of the $264 billion that the United States spent.

K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Medicaid: The Basics Diane Rowland, Sc.D. Executive Director Kaiser Commission.

Integrating Care for Medicare- Medicaid Enrollees Medicare-Medicaid Coordination Office Centers for Medicare & Medicaid Services November 2011.

1 Health and Disability Policy Briefing The American Public Human Services Association July 2007.

Medicaid Managed Care for Elderly and Persons with Disabilities Pam Coleman Texas Health and Human Services Commission October 11, 2006.

DataBrief: Did you know… DataBrief Series ● February 2011 ● No. 12 Dual Eligibles Across the States In 2008, dual eligibles as a percent of the total Medicare.

Medicaid’s Role in Long-Term Services and Supports Alliance of Health Insurers September 9, 2014.

1 Health Policy Series: Medicaid Nina Owcharenko Director Center for Health Policy Studies The Heritage Foundation October 11, 2011.

“Medicaid Made Simple” in West Virginia House Government Organization Committee February 2, 2012 Renate Pore, Health Policy Director WV Center on Budget.

MEDICAID – CONTEXT FOR CHANGE Mike Cheek Vice President, Medicaid and Long Term Care Policy.

Capitation in Medicaid – Past Trends and Future Growth Projection Five Slide Series, Volume 1 June 2013.

Avalere Health LLC | The intersection of business strategy and public policy Long-Term Care Financing Reform: A Federal and Private Insurance Partnership.

Opportunities to Leverage HIT for Medicaid Reform in New York Rachel Block, United Hospital Fund C. William Schroth, NYS Department of Health eHealth Initiative.

©Copyright 2004 All Rights Reserved Reinhart Boerner Van Deuren s.c. Wisconsin Taxation and Spending LaFollette School January 2005 By Thomas R. Hefty.

Importance of Managed Care and Safety Net Health Plans to Medicaid Meg Murray Executive Director Association for Community Affiliated Plans Medicaid Congress.

SoonerCare and National Health Care Reform Oklahoma Health Care Authority Board Retreat August 26, 2010 Chad Shearer Senior Program Officer Center for.

MEDICARE ADVANTAGE SPECIAL NEEDS PLAN AN OVERVIEW.

Special Needs Plans Susan Nedza, M.D., M.B.A. Chief Medical Officer, CMS Chicago Regional Office March 23, 2006.

Health Insurance Coverage of the Nonelderly, 2010 * Medicaid also includes other public programs: CHIP, other state programs, Medicare and military-related.

Exhibit 2. Medicare Enrollment, 1970–2080 Enrollment in millions Source: Centers for Medicare and Medicaid Services, 2013 Annual Report of the Boards of.

Virginia’s Blueprint for the Integration of Acute and Long-Term Care Services The Second National Medicaid Congress Cindi B. Jones, Chief Deputy Director.

“Rightsizing Medicaid” Kathy Kuhmerker Vice President, The Lewin Group Empire Center for New York State Policy/Center for Governmental Research Conference.

Issues and Challenges Facing Medicare Mark L. Hayes.

A Presentation of the Colorado Health Institute 1576 Sherman Street, Suite 300 Denver, Colorado Hot Issues in.

Medicaid at a Crossroad Cindy Mann Center for Children and Families Georgetown University Health Policy Institute (202)

K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Robin Rudowitz Associate Director Kaiser Commission on Medicaid and the Uninsured.

THE COMMONWEALTH FUND The 2009 Congressional Health Reform Bills: Insurance Coverage Sara R. Collins, Ph.D., Vice President Rachel Nuzum, M.P.H., Senior.

MassHealth Managed Care for Older Members and Members with Disabilities Lori Cavanaugh Director of Purchasing Strategy NASHP Annual Conference October.

Federal-State Policies: Implications for State Health Care Reform National Health Policy Conference February 4, 2008.

Return to Tutorials Tricia Neuman, Sc.D. Director, Medicare Policy Project Vice President, Kaiser Family Foundation For KaiserEDU June 2009 Medicare 101:

Medicaid “Reform” and Mental Health Leighton Ku Senior Fellow Presentation at NAMI Conference, June 2005

Chart 1.1: Total National Health Expenditures, 1980 – 2011 (1) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released.

2009 ACAP CEO Summit Controlling Long Term Care Costs and Improving Quality: The Role of Medicaid Managed Care Hank Osowski Senior Vice President SCAN.

Medi-Cal 1115 Demonstration Waiver 14 th Annual ITUP Conference February 10, 2010.

CENTERS for MEDICARE & MEDICAID SERVICES Tom Scully CMS Administrator.

Janet Grant CareSource Management Group Executive Vice President Business Development and Regulatory Affairs Medicaid Conference September 24, 2008 Contracting.

Stan Rosenstein Former California Medicaid Director Retired December 22, 2008.

1 The Role of Managed Care in Strengthening Medicaid 2 nd Annual Medicaid Congress June 15, 2007 John Monahan President, State Sponsored Business.

Figure 1 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Dual Eligibles: The Basics Barbara Lyons, Ph.D. Director, Kaiser Commission on.

SOURCE: Kaiser Family Foundation estimates based on the Census Bureau's March 2014 Current Population Survey (CPS: Annual Social and Economic Supplements).

Medicaid Per Capita Costs for Persons with Disabilities Five Slide Series, Volume 5 October

DataBrief: Did you know… DataBrief Series ● October 2011 ● No. 21 Dual Eligibles, Chronic Conditions, and Functional Impairment In 2006, 37% of seniors.

K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Long-Term Care: Exploring the Possibilities Diane Rowland, Sc.D. Executive Vice.

The Building Blocks of Health Reform: Achieving Universal Coverage and Health System Savings Cathy Schoen Senior Vice President, The Commonwealth Fund.

MA REFORM: Integrated Care for People Dually Eligible for Medicare and Medicaid Community Stakeholders Meeting December 5, 2011 Minnesota Department of.

Chart 1.1: Total National Health Expenditures, 1980 – 2013 (1) Source: Centers for Medicare & Medicaid Services, Office of the Actuary. Data released.

The State Perspective: Rebalancing Long-Term Services and Supports Cynthia H. Woodcock Alliance for Health Reform Briefing October 3, 2011.

THE BUDGET… Every year, the President and Congress must appropriate funds Budget – a policy document allocating burdens (taxes) and benefits (expenditures)

Overview of Section 1115 Medicaid Demonstration Waivers Samantha Artiga Kaiser Commission on Medicaid and the Uninsured Kaiser Family Foundation For National.

K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured New Models for Medicaid: A View from the Think-Tank Perspective Diane Rowland, Sc.D. Executive.

New York's Medicaid Expansion of : Implications for Other States under the ACA Michael Birnbaum Vice President United Hospital Fund June 14, 2011.

Health Care Reform IT’S COMPLEX! Jeffery Thompson, MD MPH Chief Medical Officer Washington State Medicaid.

A Strong Foundation for System Transformation Barbara Coulter Edwards Director Disabled and Elderly Health Programs Group Center for Medicaid, CHIP and.

MEDICAID CHANGES UNDER PPACA George H. Ritter Wise Carter 401 E. Capitol Street Jackson, Mississippi (601)

K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Medicaid’s Origin Enacted in 1965 as companion legislation to Medicare (Title XIX)

1 Cindy Mann, JD Director Center for Medicaid and State Operations Centers for Medicare & Medicaid Services Institute of Medicine April 16, 2010 Cindy.

Impact of the AHCA on Medicaid

Child health advocacy update

What Does a Debate on National Health Care Reform Mean for Medicaid in New York? James R. Tallon, Jr. President United Hospital Fund July 10, 2008.

Department of Medical Assistance Services

Medicaid and Health Reform: A Cautionary View

Major Sources of Savings Compared with Projected Spending, Net Cumulative Reduction of National Health Expenditures, 2010–2020 Affordable Coverage for.

Setting the Stage for Federal Action on Medicaid Reform June 6, 2006

Medicare Reform: Implications for Pharmaceutical Manufacturers

Presentation transcript:

The National Medicaid Congress “Medicaid Managed Care: Opportunities and Implications of State Expansions” Brian Coyne Senior Vice President Federal Government Relations AMERIGROUP Corporation June 6, 2006

AMERIGROUP Overview Multi-State Medicaid Managed Care 9 states and District of Columbia Approximately 1.1 million lives covered Multi-Products –Families & Kids (TANF & CHIP) –Elderly and Disabled (SSI) –Dual Eligibles (Special Needs Plan/Medicare Advantage Plan)

AMERIGROUP Overview

Personal Experience 1992 Small State, Big Ideas: RIte Care Coverage of Children 0 to 6 (“All kids enter school healthy and ready to learn”) Linked to Managed Care Foundation for Continued Coverage Expansion

Medicaid Managed Care Enrollment (In millions) States Adopt Managed Care Source: Kaiser Family Foundation

Medicaid Spending FY 2003: $283B Sources: CMS, Kaiser Family Foundation and Lewin Group 36% 5.5% 42.5% 16%

Medicaid Managed Care Medicaid Managed Care Spending as percent of Medicaid Source: Lewin Group

Managed Care Expansion Opportunities: Non-Duals $75 Billion Expenditures available for Capitation (excluding duals): –Nearly 1/3 of all Medicaid spending not currently in capitation arrangements $46 Billion from SSI (non-duals) –60% of potential expenditures available for capitation from SSI-only program Source: Lewin Group

Managed Care Expansion Opportunities: Dual Eligibles Over 40% Medicaid Spending for Dual Eligibles 2/3 Expenditures for LTC Services Special Needs Plus (SNP) potential for acute care coordination with Medicaid

Barriers/Challenges Upper Payment Limit (UPL) Integrating Medicare/Medicaid through SNP Recognizing savings associated with Managed Care Long-Term Care Actuarial Soundness Medicaid Reform (Expand or Contract)

Large and Growing Program $335B $161B Medicaid Expenditures $724B 2016E Source: The Congressional Budget Office

Source: 2003 State Expenditures Report, National Association of State Budget Officers Fastest Growing State Expenditure 8.0% Medicaid E&S Education Transportation Higher Education All Other Public Assistance Corrections