Medicaid payment and financing
This term refers to what percent of Medicaid costs the federal government covers in each state
What is the FMAP
This document describes the state’s Medicaid managed care goals and objectives as well as the performance measures it uses to oversee managed care performance
What is a quality strategy
This project assists with budget neutrality requirements in Medicaid
What is the 1115 demonstration support project
This presidential administration signed the 1115 demonstration authority into law
What is the Kennedy administration
Congress created this "Part" of Medicare in 2003
What is Medicare Part D
In this type of delivery system, providers bill the state directly for Medicaid benefits
What is fee for service
This organization maintains the HEDIS measures used to oversee managed care performance
What is NCQA
This project oversees state compliance with external quality review and quality strategy requirements
What is the Core Set project
The Affordable Care Act created this eligibility group
What are expansion adults
These types of plans are Medicare managed care plans
What are Medicare Advantage plans
Medicaid covers the largest proportion of costs for this category of services in the United States
What are LTSS
This type of survey is commonly used to measure patient satisfaction in managed care
What are CAHPS surveys
This project developed the plan to state reporting template and our SDP analysis activities
What is the MMC-IDS project
Congress created the CHIP program in this decade
What are the 1990s
This person leads CMMI
Who is Abe Sutton
Actuaries build capitation rates so that plans can reasonably achieve this MLR percent
What is 85 percent
This type of organization validates performance improvement projects, performance measures, and network adequacy on behalf of Medicaid agencies
What is an EQRO
This project helped Iowa redesign its HCBS waivers
What is the HOME project
This was the first state to implement Medicaid managed care statewide
What is California
This new CMMI model encourages use of tech enabled services to address chronic disease under Medicare Part B
What is the ACCESS model
CMS was primarily concerned with SDPs financed with these types of funds when it decided to require states to collect 'hold harmless attestations'
What are provider taxes
The 2016 Medicaid managed care final rule required states to establish these types of network adequacy standards
What are time and distance standards
This current project with CMS helps states improve Medicaid managed care encounter data
What is the MACBIS project
These are the three authorities that Congress has created that allow states to implement managed care
What are state plan authority (or 1932(a) or state plan amendments), 1915 waivers, and 1115 demonstrations
CMS uses this process to adjust payments to Medicare Advantage plans based on the health status of their enrollees
What is the risk adjustment process