Public Programs

Medicare Advantage: Improving Health Care Quality - [PDF]

This analysis confirms that MA plans deliver effective and consistent care for a number of important procedures at higher rates compared to the traditional FFS program. Seniors and Medicare beneficiaries with disabilities, especially those with high-risk conditions, such as diabetes, heart disease, breast cancer, and depression, can rest assured knowing that they can rely on their MA plan to successfully provide access to care and the services they need to live better lives.

AHIP Statement on More Affordable Prescription Drug Coverage for Seniors

America’s Health Insurance Plans (AHIP) President and CEO Karen Ignagni released the following statement today in reaction to the announcement by CMS that Medicare Part D premiums for 2012 have declined slightly from 2011.

Capitol Hill Briefing on Access and Quality in Medicaid Managed Care

AHIP hosted a Capitol Hill briefing on how Medicaid health plans improve access and quality of care for beneficiaries while providing cost savings to states. The briefing featured presentations from four Medicaid health plan executives.

Medicaid Health Plan Enrollment and Participation Trends, May 2011

This report by America’s Health Insurance Plans (AHIP) analyzes enrollment and participation trends in Medicaid managed care plans. Of the 50.5 million Medicaid beneficiaries nationwide, 23.9 million were enrolled in a Medicaid health plan as of June 30, 2009, an increase of 2.4 million since 2008.

USA Today: States turn to private insurance companies for managed care

Kaiser Health News/USA Today examine how states are turning to Medicaid managed care plans to provide care for long-term care patients.

Medicaid Health Plans: Adding Value for Beneficiaries and States - [PDF]

This synthesis of research by America’s Health Insurance Plans (AHIP) demonstrates that Medicaid health plans provide high quality accessible care to beneficiaries and value to states.

Innovations in Medicaid Managed Care

Health insurance plans are implementing a multitude of creative programs to improve quality and efficiency in Medicaid.

AHIP Report: Medicaid Managed Care Cost Savings - A Synthesis of Fourteen Studies - [PDF]

According to the Lewin Group's review of 14 studies, Medicaid managed care has saved states up to 19% compared with fee-for-service Medicaid.

Amerigroup: Coordinated Case Management

AHIP member company produced video - Amerigroup: Coordinated Case Management

Amerigroup: Dedicated Doctors and Nurses

AHIP member company produced video - Amerigroup: Dedicated Doctors and Nurses 

EmblemHealth: Finding Creative Ways for a Patient to Afford Treatment

EmblemHealth: Overcoming Alcoholism and Addressing Unmet Medical Needs

EmblemHealth: Reaching Out to Patients with Complex Conditions

Excellus BCBS: Keeping Medications Affordable

Excellus Blue Cross Blue Shield - Keeping Medications Affordable

Excellus BCBS: Overcoming Confusion about Medications after a Hospital or Rehab Stay

Excellus Blue Cross Blue Shield Video - Overcoming Confusion about Medications after a Hospital or Rehab Stay

Excellus BCBS: Protecting Patients from Adverse Drug Interactions

Excellus Blue Cross Blue Shield Video - Protecting Patients from Adverse Drug Interactions

Group Health Cooperative: Living Well with Chronic Conditions

AHIP member company produced video - Group Health Cooperative: Living Well with Chronic Conditions 

Group Health Cooperative: The Medical Home

AHIP member company produced video - Group Health Cooperative: The Medical Home

HealthPartners: Achieving Results that Make a Difference for Diabetes Patients

HealthPartners Video - Achieving Results that Make a Difference for Diabetes Patients

HealthPartners: Coaching Patients on Reaching Goals for Better Health

HealthPartners Video - Coaching Patients on Reaching Goals for Better Health

HealthPartners: The Diabetes Wizard

HealthPartners Video -The Diabetes Wizard

Medicaid Health Plans

Medicaid health plans are playing a growing role in the Medicaid program. More than 24 million low-income individuals throughout the country-- representing nearly 50 percent of total Medicaid enrollment-- rely on Medicaid health plans. Medicaid health plans are at the forefront of implementing systems and programs that not only provide better care coordination for beneficiaries, but also help states control escalating program costs and achieve a high value for their health care dollars.

Medicare Advantage

Medicare Advantage is the part of Medicare through which private health plans provide comprehensive medical coverage to seniors and other Medicare beneficiaries.

Almost 12 million Americans, or roughly 25 percent of all Medicare beneficiaries, have chosen to enroll in a Medicare Advantage plan because of the better services, higher-quality care and additional benefits these plans provide.

Medicare Part D

Medicare Part D is Medicare’s prescription drug program that went into effect on January 1, 2006. Participation in Medicare Part D is voluntary, although most beneficiaries choose to enroll. Medicare Part D beneficiaries have a choice of either a stand-alone prescription drug plan (PDP) with a separate premium or a Medicare Advantage plan with an attached drug benefit (MA-PDP). A highly popular program, Part D provides seniors and other Medicare beneficiaries with coverage of a wide range of brand-name and generic prescriptions. Medicare beneficiaries are often obligated to pay co-payments for certain drugs, although some medications (often low-cost generic drugs) may require no co-pay at all. In addition, beneficiaries with high drug expenses may find themselves temporarily in the Medicare coverage gap (also known as the “donut hole”), although the ACA takes steps to eliminate the gap over the next several years. 

Molina: Shots for Shorties and Check Up or Check Out

AHIP member company produced video - Molina: Shorts for Shorties and Check Up or Check Out 

SCAN Health Plan: A Better Way to Care

AHIP member company produced video - SCAN Health Plan: A Better Way to Care