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Vermont Medicaid has been able to make some important changes to the delivery of long-term care services, thanks to its unique Choices for Care waiver.
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Will funding from the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA), propel state Medicaid programs forward with the use of electronic health records (EHRs)? Or will state fiscal crises or other unforeseen problems prevent the hoped-for progress?
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Medicaid providers may be eagerly awaiting incentives to purchase electronic health records (EHRs) for their practice, as a result of funding from the HITECH Act. However, at this juncture, some troubling questions remain.
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In Oklahoma, a health management program targets high-cost and/or high-utilization Medicaid clients, both adults and children. "Through predictive modeling, we identify our members, adults and children, at risk for higher costs or utilization. If they are within the targeted top 5,000 at highest risk and agree to participate, we enroll them in our health management program," says Marlene Asmussen, RN, director of SoonerCare Medicaid care management and health management.
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Lean management techniques helped Lahey Clinic Medical Center, North Shore, in the city of Peabody, MA, boost patient satisfaction and reduce emergency department (ED) waiting times.
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Just 10% of enrollees, two-thirds of whom have a chronic condition, account for 72% of spending on children in Medicaid and the Children's Health Insurance Program(CHIP), according to a study published by Genevieve M. Kenney, PhD, Thomas Selden, and Joel Ruhter in Health Affairs, "Containing Costs And Improving Care For Children In Medicaid And CHIP."
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Integrating care for dual-eligibles clearly presents many opportunities for state Medicaid programs. Unfortunately, progress has been slow, according to The Commonwealth Fund's November 2009 policy brief "Supporting Alternative Integrated Models for Dual Eligibles: A Legal Analysis of Current and Future Options."
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Often the best research compliance programs are not the result of overnight inspiration, but are developed through a long, experience-building process.
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Compliance officials can call principal investigators (PIs) and let them know about a scheduled audit, but chances are the site will be inadequately prepared for an efficient audit visit.
