from the Kaiser Family Foundation provides an in depth examination of the changes taking place in state Medicaid programs. This report highlights policy changes implemented in state Medicaid programs in FY 2014 and those planned for implementation in FY 2015 based on information provided by state Medicaid Directors. Key areas covered include changes in eligibility and enrollment, delivery systems, provider payments and taxes, benefits, pharmacy programs, program integrity and program administration. Medicaid programs across states have continued to increase their focus on delivery system and payment reforms with the goals of improving quality of care and controlling costs. States are expanding their reliance on managed care but also implementing innovative delivery system and care coordination arrangements, some of which are new options made available by the ACA. In coordination with these efforts, Medicaid programs are also focused on better ways to deliver long-term care services and supports by expanding home and community-based service programs. More states have been able to implement provider rate increases as well as benefit increases as the economy has continued to slowly recovery. Most directors reported staffing and resource constraints in the face of the magnitude of changes occurring in the program today.