navigating the medicaid reform landscape (medicaid reform info graphic)
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ICF International Medicaid Reform InfographicTRANSCRIPT
© ICF International 2014
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CENTER FOR MEDICARE & MEDICAID INNOVATION
ACCOUNTABLE CARE ORGANIZATIONS
COMMUNITY BASED SERVICES
5 MILLIONPOOR UNINSURED ADULTS WILL FALL INTO THE “COVERAGE GAP”
THE COVERAGE GAP
HAVE YET TO EXPAND MEDICAID, PREVENTING
24 STATES
5.7 MILLION PEOPLE FROM OBTAININGHEALTH INSURANCE COVERAGE IN 2016
CID GRA 0714 0165
PRIVATE SECTOR DELIVERY OF MEDICAID PROGRAMS
The Medicaid Reform DynamicThere’s no doubt about it: The Medicaid Dynamic is revolutionizing healthcare delivery on a national scale. With private sector companies at the heart of Medicaid service delivery, they hold the keys to the majority of the infrastructure feeling the impact of reform. These private stakeholders over the next decade will help drive the definition and delivery of the reform landscape. ICF helps to navigate the private sector road to healthcare reform, unlocking optimal solutions and best practices to meet these challenges—with the Healthcare Delivery Series.
Sources (confirmed as of May 2014)Centers for Medicare and Medicaid Services (CMS), Kaiser Foundation website: kff.org/medicaid/issue-brief/how-is-the-aca-impacting-medicaid-enrollment/Kaiser Foundation website: kff.org/medicaid/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/Kaiser Foundation website: kff.org/health-reform/issue-brief/the-coverage-gap-uninsured-poor-adults-in-states-that-do-not-expand-medicaid/ Kaiser Foundation website: kff.org/medicaid/fact-sheet/state-demonstration-proposals-to-integrate-care-and-align-financing-for-dual-eligible-beneficiaries and kff.org/medicaid/state-indicator/duals-share-of-medicaid-spending/ Kaiser Foundation website: kff.org/health-reform/issue-brief/individual-market-enrollment-ticks-up-in-early-2014/ CHCS Issues Brief from January 2014: chcs.org/media/Churn_1_30_2014_final.pdf FierceHealthPayer article by Dina Overland, July 3, 2014: fiercehealthpayer.com/story/white-house-continues-pressure-states-expand-medicaid/2014-07-03
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KEY SUCCESS FACTORS TO DELIVERY SYSTEM REFORM
THE ROAD TO HEALTHCARE REFORM
DID YOU KNOW… Medicaid Reform Fast Facts
COORDINATING CARE FOR DUAL ELIGIBLES
MEDICAID PAYMENT DEMONSTRATION PROJECTS
NEW ACA-INFLUENCED MEDICAID PROGRAMS
EXPANDED MEDICAID COVERAGE
HEALTH INSURANCE MARKETPLACE
7 MILLION ARE LIKELY TO EXPERIENCE COVERAGE SHIFTS BETWEEN MEDICAID AND MARKETPLACE POLICIES ANNUALLY
$96 MILLION AMERICANS ARE ELIGIBLE TO RECEIVE MEDICAID OR MARKETPLACE SUBSIDIES
29 MILLION ARE LIKELY TO “CHURN” BETWEEN ALL COVERAGE OPTIONS
STATE MEDICAID EXPANSION
IMPLEMENTING EXPANSION IN 201427OPEN DEBATES3NOT MOVING FORWARD AT THIS TIME21
4
IN 2010, DUAL ELIGIBLES ACCOUNTED FOR
28% – 41%OF MEDICAID SPENDING FOR OVER 25 STATES
DUAL ELIGIBLES9 MILLION
MEDICAIDMEDICARE
BETWEEN
3.3–4.2 MILLIONPEOPLE HAVE SIGNED UP FOR MARKETPLACE COVERAGE AS OF FEBRUARY
PEOPLE HAVE INDIVIDUAL MARKET COVERAGE AS OF MARCH 2014
15 MILLIONABOUT
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MEDICAID
From exchange implementation to maintaining federal mandates, and enrollment streamlining to care coordination—sustainable yet adaptable systems are key.