This brief presents a process that staff in state Medicaid agencies can use to engage resources – such as benchmarks, subject matter experts, and advisory groups—in the development of their access monitoring review plans.
Related Publications for Jenna Libersky
Leveraging Benchmarks, Advisory Groups, and Experts to Understand Access in MedicaidAug 01, 2018
Medicaid Managed Care Enrollment and Program Characteristics, 2016Apr 01, 2018
The data and information presented in this report were collected directly from all states, the District of Columbia, and US territories.
Managed Long-Term Services and Supports: Interim Evaluation ReportJan 31, 2018
This interim evaluation examines how utilization of specific services by MLTSS enrollees compares to that of fee for service (FFS) beneficiaries using LTSS.
Value-Based Payment in Nursing Facilities: Options and Lessons for States and Managed Care PlansNov 06, 2017
To improve the value of care provided in nursing facilities, payers are experimenting with value-based payment (VBP) approaches that link financial rewards to measures of quality. Drawing on findings from interviews with state officials and plan representatives, this brief describes the VBP approaches...
Managed Long-Term Services and Supports Design Plan Supplement: Interim Outcomes EvaluationJun 30, 2017
The Medicaid 1115 Demonstration Evaluation Design plan, prepared by Mathematica Policy Research and submitted to the Centers for Medicare & Medicaid Services (CMS) in May 2015 (Irvin et al. 2015), proposed a theoretical evaluation strategy for MLTSS programs.
Who Enrolls in Medicaid Managed Care Programs that Cover Long-Term Services and Supports? Implications of Enrollee Diversity for a National Cross-State EvaluationJun 30, 2017
This issue brief supports the national evaluation of Medicaid Section 1115 demonstrations by describing the diversity of the beneficiary groups enrolled in 35 MLTSS programs operating in 23 states as of July 2016.
Medicare Basics: An Overview for States Seeking to Integrate Care for Medicare-Medicaid EnrolleesJun 13, 2017
This technical assistance brief explains important Medicare and Medicaid coverage, provider and health plan payment, and beneficiary cost sharing issues for stakeholders seeking to structure and coordinate services for Medicare-Medicaid enrollees.
Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service AvailabilityApr 30, 2017
In a project for the Centers for Medicare & Medicaid Services Center for Medicaid and CHIP Services, Mathematica developed a toolkit to assist states in developing their network adequacy and service availability standards for Medicaid and CHIP managed care organizations (MCOs).
Trust but Verify: Tennessee’s Approach to Ensuring Accurate Functional Status Data in its Medicaid Managed Long-Term Services and Supports ProgramAug 31, 2016
This brief describes how TennCare’s robust approach to collecting and validating data on enrollees’ functional status can help other states to advance strategies for Medicaid managed long-term services and supports program rate setting.
Population Diversity in Medicaid Managed Long-Term Services and Supports Programs: Implications for Rate Setting and Risk AdjustmentAug 31, 2016
This brief discusses how states can use information on demographic and functional limitations to predict the cost of care for people with disabilities through risk adjustment and identifies variables that can affect the predictability of Long-Term Services and Supports needs and costs that may not be...
Medicaid Rate-Setting for Managed Long-Term Services and Supports: Basic Practices for Integrated Medicare-Medicaid ProgramsJul 01, 2016
Setting capitation rates for Medicaid managed long-term services and supports (MLTSS) programs is an important challenge for states. This brief summarizes basic approaches to rate-setting and risk mitigation, and presents operational challenges for states to consider in developing their MLTSS rate-setting...
Medicaid Managed Long-Term Services and Supports: Themes from Site Visits to Five StatesMar 03, 2016
To understand the growth and diversity of Medicaid managed long-term services and supports (MLTSS) programs, we visited five states in Summer 2014: Arizona, Florida, Illinois, New York, and Wisconsin. This paper presents themes related to design, implementation, oversight, and improvement of MLTSS.
Medicaid Managed Care Enrollment and Program Characteristics, 2015Jan 01, 2016
The data and information presented in this report were collected directly from all states, the District of Columbia, and US territories