June 2002
Robert Wood Johnson Foundation
Following successful children's outreach efforts, and now facing rising unemployment and health care costs, the demands on state Medicaid budgets are increasing at the same time that states have less funds available for their share of Medicaid. Governors and state legislatures have identified Medicaid as their leading "budget buster," and are looking for any means possible to control costs. The Bush Administration is permitting benefit cutbacks, while many Governors and members of Congress are seeking to increase federal Medicaid funding in the midst of an already strained federal budget.
Are there effective methods to moderate the underlying health care costs for the Medicaid population? What policy tools are available to provide quality care to Medicaid beneficiaries at a price states and the federal government can afford?
These questions are addressed in the paper, Medicare Budget Options, which was presented at the Ninth Princeton Conference, Can Health Care Spending Be Contained?, June 6-8, 2002.
Client Area: Foundations
Expertise Area: Medicaid and CHIP
December 2001
Annie E. Casey Foundation
With welfare reform, millions of families with children have shifted from reliance on cash assistance from Aid to Families with Dependent Children (AFDC) to reliance on earnings. Increases in programs providing support to low-wage workers and their families have facilitated this shift from welfare to work. Key work support programs include the Earned Income Tax Credit, food stamps, medical insurance under the State Children's Health Insurance Program and Medicaid, and subsidized childcare. By "making work pay," these work support programs have helped families move from welfare to work and have improved family well-being. This paper presents innovative policy options for improving access to the Food Stamp Program (FSP). It presents background on the current programs and the rationale for why a new approach is needed; suggests principles to serve as a guide in designing a new approach; presents options for making the benefits available under the FSP readily accessible to eligible working families; and discusses where to go from here and lays out first steps.
Client Area: Foundations
Expertise Area: Income Security
August 2001
Kansas Health Foundation
The manual serves as a guide to the Kansas School Health Inititative database, which was developed using Microsoft Access. The School Health Center database was designed to help track the students enrolled in school health centers and the encounters with those students. In addition, the database produces monthly reports that provide center staff with demographic, socioeconomic, and health characteristics of the population enrolled in and using the school health center.
Client Area: Foundations
June 2001
California HealthCare Foundation
Lewin contact: Lisa Chimento
The California HealthCare Foundation commissioned The Lewin Group to conduct a business case analysis of Health-e-App---an interactive, Web-based enrollment application designed to expedite and simplify the enrollment of children and pregnant women in California's Medi-Cal (Medicaid) and Healthy Families (SCHIP) programs.
Modeled on the state's four-page joint Medi-Cal and Healthy Families mail-in paper application, Health-e-App offers unique features like real-time preliminary program eligibility determination and application tracking that allows community-based enrollment workers to inform inquiring clients of the application's status at different points.
A pilot test of Health-e-App demonstrated that state-of-the-art technology can be applied to improve systems for enrolling low-income individuals in public health insurance programs and to enhance stakeholders' understanding of the entire application process.
Client Area: Foundations
Expertise Area: Medicaid and CHIP
June 2001
California HealthCare Foundation
The study provides details on fee-for-service Medicaid payment rates for 50 common medical services, including office visits, surgeries, and tests. The report contains payment rates for all 50 states and the District of Columbia.
Client Area: Foundations
Expertise Area: Medicaid and CHIP
October 2000
Annie E. Casey Foundation
This report reviews the disability literature in order to examine the disability community's efforts to help individuals with significant disabilities access and maintain employment; and identify how welfare agencies can learn from and build upon lessons from the disability community. The report highlights strategies for increasing employment among people with disabilities, reviews the use of cash and in-kind supports to increase employment, outlines what is known about transitional services for persons with disabilities, and summarizes the key lessons for the TANF community.
Client Area: Foundations
Expertise Area: Employment, Training, and Workforce Development
September 2000
Kansas Health Foundation
The purpose of this manual is to provide a performance management system and reporting tools for use by the Kansas School Health Center Initiative. The performance management system consists of five monitoring and measurement components: 1) Student Profiles; 2) Student Utilization Reports; 3) Health Risk Surveillance; 4) Client Satisfaction Monitoring; and 5) Annual Performance Measurement. Used together, the monitoring and measurement components enable program staff to demonstrate accountability to a variety of constituencies and to make evidence-based decisions about administrative, program and service improvements.
Client Area: Foundations
September 2000
Robert Wood Johnson Foundation
In January of 2000, the Robert Wood Johnson Foundation (RWJF) sponsored the "Health Coverage 2000" conference at which eight major health care organizations and associations introduced proposals to expand health insurance coverage. Some of those proposals were introduced as the next steps toward universal health coverage and two of them would incrementally phase in universal insurance coverage by the middle of this decade. The incremental reform proposals included various expansions of Medicaid and the State Children's Health Insurance Programs (SCHIP), changes in tax subsidies for insurance including modifying the current tax exclusions and/or introducing tax credits for health insurance, and expansion of high-risk pools. Lewin was asked to estimate the cost and coverage impacts of the eight proposals. Assuming full implementation in 2001, Lewin estimated that the incremental reform proposals would cost between $15.4 billion and $59.1 billion and would reduce the number of uninsured by 7.3 million to about 19 million persons. Therefore, the incremental reform proposals would cover no more than about 40 percent of the uninsured. The universal coverage programs would cost between $324 billion and $454 billion per year. The incremental reform proposals specified no new revenue sources to cover the cost of the programs. However, the universal coverage proposals did include new revenues that would cover most if not all of the costs of the programs.
Client Area: Foundations
Expertise Area: Health Reform
May 2000
The Commonwealth Fund
This report explores six states' experiences with eligibility, outreach, and enrollment as they developed their State Child Health Insurance Program. It explores how the design and administration of state incremental insurance expansions affect access to health insurance coverage and, ultimately, access to all health care services. The study was intended to inform national policy discussion about these publicly financed expansions and to provide early feedback for states as they implement insurance programs for low-income families and individuals.
Client Area: Foundations
Expertise Area: Medicaid and CHIP
March 2000
Medi-cal Policy Institute
Under the existing Medi-Cal managed care program, enrollees are free to disenroll from their existing health plan at any time – with the disenrollment becoming effective on the first of the upcoming or ensuing month. States have the option, under provisions of the Balanced Budget Act of 1997 (BBA), to restrict beneficiaries' latitude to voluntarily disenroll from their existing health plan. The Medi-Cal Policy Institute engaged The Lewin Group to evaluate the pros and cons of implementing this feature, known as "lock-in," in California.
The report contains an overview of the BBA provisions; an overview of state experiences and perspectives; data analysis of a lock-in policy for Medi-Cal; and pros and cons, and policy considerations of a lock-in policy for Medi-Cal.
Client Area: Foundations
Expertise Area: Medicaid and CHIP
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