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There is no question that states are working hard to get better value for their Medicaid dollar by implementing various quality initiatives with an eye toward reducing long-term costs. "They are constantly trying to work on program integrity issues. But the problem with some of the quality things, in particular, is that it's hard to see overnight savings," says Robin Rudowitz, a principal policy analyst for the Kaiser Commission on Medicaid and the Uninsured in Washington, DC. "States are still implementing those things.
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Hospitals are losing large amounts of money on extra and inappropriate diagnostic testing and procedures, as well as outpatient procedures performed in the inpatient setting, because third-party payers frequently are denying the claims...
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During Utah's last legislative session, a decision was made to commit a minimal amount of dollars to Medicaid expansion, since it was unknown whether the enrollment growth surge the state was seeing would continue.
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Eight state teams are setting out to increase their Medicaid and Children's Health Insurance Program (CHIP) enrollees' access to high-performing medical homes. They will do so, in part, by learning from the experience of eight state teams who came before them.
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Medicaid health plans improve quality and yield cost savings ranging from half of 1% to 20%, according a March 2009 report from The Lewin Group in Falls Church, VA, "Medicaid Managed Care Cost Savings-A Synthesis of 24 Studies.
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Type 2 diabetes can be prevented or delayed.
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To improve communication between health care professionals and patients, Doris Doherty, MA, BSN, RN, patient/family education coordinator at Franciscan Skemp/Mayo Health System in La Crosse, WI, helped create educational programs for staff and consumers that address health literacy.
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Electronic games are good educational tools, says Hadi Kharrazi, MD, PhD, assistant professor at the School of Informatics at Indiana University-Purdue University Indianapolis.
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Older patients who are at high risk for health care utilization are staying healthier and out of the hospital thanks to a new primary care enhancement program called "Guided Care."
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Following the success of a program that provides remote monitoring of chronically ill patients in poverty-stricken rural areas, Roanoke Chowan Community Health Center in Ahoskie, NC, is replicating the program at six other community health centers in North Carolina.
