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With states facing a bleak economic forecast, attention to high-cost populations within Medicaid is growing.
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About 24% of Colorado's Medicaid clients are either elderly or in a disability category, and this group accounts for about 66% of total expenditures.
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Medicaid enrollees often face gaps in insurance coverage, even though they remain eligible for the program, causing them to "churn" in and out of the program.
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A long list of proposed cost- containment possibilities for New Mexico's Medicaid program never happened, due to funding the state received from the American Recovery and Reinvestment Act (ARRA) of 2009. However, in FY 2010, "all possibilities are back on the table for consideration," according to Carolyn Ingram, New Mexico's Medicaid director.
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Helping Medicaid directors to pursue innovation, while delivering higher-quality, more cost-effective health care services: this is the goal of a new Medicaid leadership program launched by The Robert Wood Johnson Foundation.
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Shirley Munkberg, acting office chief in the Office of Quality and Care Management of Washington's Health and Recovery Services Administration, acknowledges that "it takes care management programs a while to mature and show cost savings." However, when two of the state's recently implemented care management programs were evaluated, a statistically significant decrease in mortality was found.
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Infection preventionists and their employee health colleagues undertaking a mandated program to immunize health care workers against flu invariably will run into four groups of people:
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Inability to find an attorney who will take a malpractice case on a contingency fee basis. An inability to find an expert who can conclude to a reasonable degree of medical certainty that the ED physician breached the standard of care or proximately caused injury/death. Strong defense experts. Strong testimony from defendant physicians. Damaging admissions by the plaintiff's experts at deposition. A decision by the patient or family to resolve the matter now without going through the ordeal of a trial.