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The argument of some state policymakers, says Michael Sparer, PhD, JD, department chair and professor of health policy and management at Columbia University's Mailman School of Public Health in New York City, is that the federal government is significantly increasing its oversight of the Medicaid program and its demands on state Medicaid officials; "and they believe strongly that that's the wrong way to go."
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Forty-six states are actively building delivery and distribution systems to ensure that programs in chronic disease self-management are readily available to individuals with chronic conditions, especially older adults, says Sue Lachenmayr, MPH, program associate at the Center for Healthy Aging in Washington, DC.
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Over the past year, eight states Alabama, Iowa, Kansas, Maryland, Montana, Nebraska, Texas, and Virginia have been working with the National Academy for State Health Policy (NASHP) to develop medical home programs in their Medicaid and Children's Health Insurance Programs.
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An innovative pilot program in Massachusetts will soon be implemented, with the goal of improving the care of children with asthma, reports David Polakoff, MD, chief medical officer of MassHealth, the Massachusetts Medicaid program. "We hope to implement this as soon as possible," he says. "This is an idea that has been kicking around for awhile; it has been tried in some small-scale pilots."
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