Publisher's Synopsis
Medicaid is among the nation's largest purchasers of health services, spending $432 billion in fiscal year (FY) 2011 on health care and long-term services and supports (LTSS) for 70 million enrollees. IN the same year, the State Children's Health Insurance Program (CHIP) made expenditures of nearly $12 billion on behalf of 8 million children. Medicaid enrollees are an especially diverse group - including low-income children and adults, pregnant women, persons with life-long disabilities, and seniors - some of whom are relatively healthy and others who are high users of acute care and LTSS. Medicaid plays a critical role for its enrollees, and it also plays a significant role in the health care system, helping to provide access for millions of people who would otherwise remain uninsured or underinsured, improving population health, and shoring up other payers by covering some of the nation's highest-need and highest-cost patients. As part of its statutory charge, each June the Medicaid and CHIP Payment and Access Commission (the Commission) reports on its review of the Medicaid and CHIP programs within the context of the health care system. This Report to the Congress focuses on issues that are central to the goals of the Medicaid program, including obtaining value as a purchaser of health care services, monitoring enrollees' access to services, and evaluating access to care for non-elderly adults. In support of Medicaid and CHIP policy analysis, the Report also includes Medicaid and CHIP Program Statistics (MACStats), which provides statistics on program enrollees and spending. MACStats is based on both federal administrative data and survey data, providing a detail profile of the Medicid and CHIP programs in a single source. The Report is divided into several sections and a statistical supplement. Access and Value: Issues for Medicaid and CHIP as Purchaser focuses on the role of Medicaid and CHIP as significant purchasers of health care and on the goal of achieving value within the programs. Data Sources for Monitoring Access to Care in Medicaid and CHIP identifies principles for developing a monitoring approach focused on both immediate and ongoing access issues. Access to Care for Non-Elderly Adults presents new analysis evaluating access to care, by comparing non-elderly adults enrolled in Medicaid with those having employer-sponsored insurance and those who are uninsured. MACStats presents updated data on the Medicaid and CHIP populations, Medicaid enrollment and benefit spending, and Medicaid managed care. MACStats sections include: Trends in Medicaid Enrollment and Spending; Health and Other Characteristics of Medicaid/CHIP Populations; Medicaid Enrollment and Benefits Spending; Medicaid Managed Care; and Technical Guide to the June 2012 MACStats.
