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Impact of the Proposed Medicaid BBA Regulation on Medicaid Managed Care

November 2000

Center for Health Care Strategies
Lewin contact: Lisa Chimento

This analysis, commissioned by the Center for Health Care Strategies, estimates the quantitative and qualitative impacts of the proposed Medicaid BBA regulation on states and health plans. Key provisions addressed in the report include initial health assessments, complaints and grievances, and quality improvement studies.

Expertise Area: Medicaid and CHIP


Review of the Medicaid 1915(c) Home and Community Based Services Waiver Program Literature and Program Data

June 2000

DHHS, Health Care Financing Administration (HCFA)
Lewin contact: Lisa Alecxih

This report reviews literature and provides a brief summary of current program statistics for the Medicaid 1915(c) Home and Community-Based Services (HCBS) Waiver program. The review is limited to literature specifically related to the 1915(c) waiver program and focuses on two categories of programs that constitute the majority of recipients and expenditures: programs serving aged individuals and individuals under age 65 with physical disabilities (A/D); and programs serving individuals with mental retardation or developmental disabilities (MR/DD). The document addresses the following six areas: History of the waiver program; Current program characteristics; The role of care management and consumer direction; Issues related to quality of care and life in HCBS waivers; Cost control mechanisms; and Evaluations of cost savings associated with the waiver program.

Client Area: Federal Government
Expertise Area: Center on Aging and Disability, Medicaid and CHIP


State Experiences with Access Issues under Children's Health Insurance Expansions

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


Contracting for Public Mental Health Services: Opinions of Managed Behavioral Health Care Organizations

April 2000

DHHS, Substance Abuse and Mental Health Services Administration (SAMHSA)

This report synthesizes the collective experiences of four managed behavioral health care organizations (MBHOs) that hold public sector managed care carve-out contracts. The views presented are those of representatives of the MBHOs who participated in a daylong focus group meeting.

Client Area: Federal Government
Expertise Area: Medicaid and CHIP, Mental Health and Substance Abuse


School-Based Mental Health Services under Medicaid Managed Care

April 2000

DHHS, Center for Mental Health Services

This study sought to learn how schools and providers of school-based mental health services work with Medicaid managed care organizations. To that end, it observed the experiences of several States and local communities in providing for the inclusion of school-based mental health services in managed care contracts. The study also explored options and models for including school-based mental health services within managed care; examined financing and reimbursement issues that might affect the viability and expansion of such services; and assessed alternative ways to maintain and expand school-based mental health services within the managed care environment.

Client Area: Federal Government
Expertise Area: Medicaid and CHIP, Mental Health and Substance Abuse


Managed Care Lock-In: Analysis of Impact on Medi-Cal

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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