Description: Republicans have promised to repeal and replace the Affordable Care Act for years. Now that they have power, what will Republican health care reform look like?

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.

Description: In this article, the authors explore how the recession has impacted new member enrollment in the various state health care programs and the resulting impact on trend.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: Budget concerns should not be allowed to override sound actuarial rate development in setting Medicaid capitation rates.

Description: This article describes the Health Insurance Providers Fee implemented through Section 9010 of the Affordable Care Act (ACA) and discusses how the fee will creates challenges in Managed Medicaid Rate development. It also offers some suggested ways to include the fee in Managed Medicaid rates.

Description: Interview of people knowledgeable about risk adjustment and the use of social determinants of health with that context for Medicaid.

Description: Background on Medicaid and description of recent changes in the program.

Description: This article discusses some of the most important considerations in implementing risk adjustment within a Medicaid Managed Care program. From Health Watch, January 2008, No. 57.

Description: This article focuses on the capitation rate development methodology for the Medicare-Medicaid Financial Alignment Demonstration. It also describes the background behind the establishment of the initiative and how it will be evaluated.