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Medicare, Medicaid, Health Reform

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Monthly Archives: August 2008

Medicare Policy Making: Quick Primer on Federal Medicare Statutes, Rules, and Waivers

The next President and Congress will face many fiscal and policy challenges from the $436 billion Medicare program. Following my earlier quick primers on Medicaid policy making and Medicare and Medicaid waivers, here is a similar briefing on the primary vehicles of Medicare policy making. As a federal health program operating nationwide, Medicare policies are made through: Federal Medicare Statutes: Title XVIII...

Medicaid Policy Making: A Primer on the Mechanisms for Federal and State Medicaid Policies

Many of my clients ask me how Medicaid policy is made, particularly for coverage, reimbursement, and managed care and other delivery systems. The $360 billion Medicaid program is highly complex and there are many nuances and exceptions, but here is a high-level primer on the basics. Given the Medicaid program's shared federal-state funding and governance, underlying complexity, and variability across...

Medicare and Medicaid Demonstration Waivers: Primer

Federal waivers are powerful tools to demonstrate Medicare or Medicaid reforms, including new payment methods, benefit packages, and delivery systems. The business and policy opportunities are considerable. Here's a quick primer. Demonstration Waivers: Historically, federal policymakers have understood the need to test new ideas in the complex Medicare and Medicaid programs. Research and demonstrations projects - whether initiated by states, health...

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