Description: This article gives part of the testimony provided to a U.S. House Subcommittee about Medicaid abuse. Specifically, it explains how families with ample means are able to skirt the law and obtain Medicaid funding of nursing home care when private Long Term Care insurance should have been considered.

Description: State Medicaid agencies have been implementing value-based payment (VBP) models for the last decade and are increasingly exploring advanced population-based payment (PBP) models that increase flexibility, predictability, and accountability for participating provider organizations. PBP models show promise in advancing Medicaid priorities, but are still in the early stages of development, and model design and implementation challenges remain. This article from the Center for Health Care Strategies explores the fundamentals of VBP and how PBP - a particular type of payment model - can help Medicaid agencies achieve goals related to care transformation and quality improvement, revenue stability, and controlling cost of care.

Description: This is the abstract for the paper, The Boomers Are Coming: A Total Cost of Care Model of the Impact of Population Aging on the Cost of Chronic and Acute Conditions in the United States. The complete paper is not available online.

Description: Comparison of Healthy Michigan and Healthy Indiana Plan Medicaid expansion programs.

Description: This article highlights several state's Medicaid innovatioins, including cutting edge payment changes based on episodes of care, patient outcomes, and quality metrics.

Description: Essay states a competing American ideals for the U.S. Health care system include free markets which foster competition, cost effectiveness and quality health care vs.public and private assistance which provides health care independent of a person’s financial means.

Description: An edited written interview with two actuaries and a public health professional on issues related to the intersection between the two fields.

Description: Beneficiaries who are eligible for both Medicare and Medicaid often have complex health needs. The two programs have not typically been well integrated and care can become uncoordinated, fragmented and incomplete. The ACA includes provisions to address the shortcomings.

Description: This session is about the details of the inception and implementation of the Oregon Health Plan. From Record of Society of Actuaries Vol. 18, No. 1B.

Description: Analysis of data from three Medicaid managed care plans examines enrollment and cost trends for newly eligible enrollees under the ACA's Medicaid expansion.