As part of the Medicare Part D pharmacy benefit scheduled for implementation in 2006 by the Medicare Prescription Drug, Improvement, and Modernization Act (MMA), beneficiaries will have a choice of private plans administering the benefit.? Although plans are required to provide access to needed drugs, the law does not require plans to provide equa
Examples of Promising Practices for Integrating and Coordinating Eligibility, Enrollment and Retention: Human Services and Health Programs Under the Affordable Care Act. 1. Streamlining eligibility determination for one program based on datalinkages with other programs
Location and Programs Practice Additional Resources Alabama – Medicaid and SNAP The state implemented Express Lane Eligibility, qualifying children for Medicaid based on SNAP findings.
This paper examines the combined effects of drug plan risk the first year of Medicare part D implementation of the combination of reinsurance, risk-adjustment and risk-corridors
This contract developed data bases to supplement the Federal Employees Health Benefits Data used to develop the drug risk adjustment system for Medicare part D drug plans for low-income and disabled populations; explored geographic variation by state in drug prices and drug utilization; and examined the joint effects on drug plan risk of the combi
Assessing the Need for a National Disability Survey: Final Report. B. Findings from a Review of National Surveys
Many existing national surveys collect disability-related information, and some do so in great detail. There is substantial variation across surveys in terms of target populations, the disability measures used, topics covered, frequency, and design. We provide an overview of the 40 national, federally-sponsored surveys we reviewed for this study,
This is the final report of a project that assesses the need for developing and fielding another national disability survey data collection effort. It presents the findings from three principal project activities designed to assess whether existing data are sufficient to answer key disability-related research questions identified by the staffs of
Developing Medicare and Medicaid Substance Abuse Treatment Spending Estimates. A. Overview of Medicare Coverage of SA Treatment
In this section, we first describe the SA treatment services covered under the Medicare program. Then, we describe the approaches Medicare uses to reimburse providers for these services. 1. Service Coverage Medicare covers a full spectrum of SA treatment services:
This is a supplemental report to the final report of a study jointly funded by ONDCP and ASPE (Medicaid Substance Abuse Treatment Spending: Findings Report). This technical report provides more detail on the methods used to make estimates, and it also describes how MPR would make similar estimates of Medicare funding for substance abuse treatment,
Improving Care for Populations Disproportionally Affected by Alzheimer’s Disease and Related Dementias. Appendix B. Data Collection Documents
Memorandum to Task Force Members Describing Data Collection Process August 31, 2012 Dear All,
Improving Care for Populations Disproportionally Affected by Alzheimer’s Disease and Related Dementias
The National Plan to Address Alzheimer’s Disease requires the Office of the Assistant Secretary for Planning and Evaluation (ASPE) and the Administration for Intellectual and Developmental Disabilities (AIDD) within the Administration for Community Living (ACL) to establish a task force to create a plan of action to address the needs of specific
Developing Quality Measures for Medicaid Beneficiaries with Schizophrenia: Final Report. IV. Lessons Learned
While we successfully developed and tested ten quality measures, development of several additional measures was not feasible given the constraints of Medicaid claims data and Medicaid payment policies. The following discussion of our experience and lessons learned is designed to be instructive for future efforts in the development of quality measu
Health Insurance Marketplace: March Enrollment Report. For the period: October 1, 2013 - March 1, 2014. Anticipated Enrollment Growth in March
Based on the experience of private employers, the Federal Employees Health Benefits Program (FEHBP), Medicare Part D, Massachusetts’ Commonwealth Care, and the Children’s Health Insurance Program (CHIP), several factors drive enrollment rates, particularly in the early months of program operation, 5 including:
Health Insurance Marketplace: Summary Enrollment Report For the Initial Annual Open Enrollment Period. Enrollment Growth in March
As expected, an enrollment surge occurred in March as the close of the open enrollment period approached for the Marketplace. This is consistent with the experience of private employers, the Federal Employees Health Benefits Program (FEHBP), and Medicare Part D. 8 Table 2 shows that approximately 0.9 million (12 percent) of the more than 8 mill
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act. Methods
This memo was prepared by analysts in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in consultation with the Office of the Actuary (OACT) of the Centers for Medicare & Medicaid Services (CMS).
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act. Summary
The Affordable Care Act, enacted in 2010, makes many changes to strengthen Medicare and provide better benefits to seniors, while slowing cost growth. As a result, average Medicare beneficiary savings in traditional Medicare will be approximately $5,000 over the 2010 to 2022 period (see Table 1). Beneficiaries who have high prescription drug spend
Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act
This report provides estimates of Medicare Parts A, B, and D savings from the Affordable Care Act to seniors and people living with disabilities enrolled in traditional Medicare. The Affordable Care Act will favorably affect beneficiary expenditures in four ways: lowering part B premiums growth, lowering beneficiary copayments and coinsurance grow
Diabetes: A National Plan for Action. Medicare Modernization Act of 2003 Improvements for Individuals with Diabetes
The new law enhances diabetes coverage for beneficiaries by adding several improvements.
Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Notes
1 National Federation of Independent Business v. Sebelius, 567 US 1, 132 S.Ct. 2566, 183 L. Ed. 2d 450 (2012).
Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Research findings
This report does not analyze how Marketplaces and Medicaid programs can best structure the application and health plan choice process. Rather, we focus on that process’s cognitive demands to understand the consumer’s mindset when faced with the additional questions posed by possible SNAP enrollment.