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Hospitalization rates in Medicaid programs were lower in areas with a greater number of primary care physicians, and in states that on average provided more outpatient visits and paid more per outpatient visit, according to a study published in Health Affairs.
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The foundation that was laid for the operation of Arkansas' Cash and Counseling demonstration and the Independent Choices program was "unique from the very start," says Deborah Ellis, a program administrator with the Arkansas Department of Human Services' Division of Aging and Adult Services. "It truly was a spirit of teamwork on all levels to implement this new program."
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The state of Arizona has proposed a $50 annual fee on childless adults in Medicaid who are obese or smokers.
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Elders and adults with severe disabilities have mostly remained under traditional fee-for-service Medicaid plans, but this is now changing, according to Thomas L. Johnson, BA, JD, president and CEO of Medicaid Health Plans of America, a Washington, DC-based trade association representing Medicaid health plans.
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As a result of the Indiana legislature voting to cut off $3 million in federal money from Planned Parenthood because it provides abortion services, the state's Planned Parenthood clinics stopped treating Medicaid patients, but a June 24 federal district court ruling blocked provisions of the state law.
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The idea of using a fee and incentive structure to motivate consumer behavior change, as Arizona is attempting to do with a proposed $50 fee on smokers and obese Medicaid clients, is certainly appealing, says Donna Friedsam, MPH, health policy programs director at the University of Wisconsin Population Health Institute in Madison.
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All of the accountable care principles that are integrated into the Affordable Care Act (ACA) require a clinical approach to the sickest, most complex and costliest patients, says Diane E. Meier, MD, FACP, director of the Center to Advance Palliative Care at the Mount Sinai School of Medicine in New York City, because they all begin to move the system away from the fee-for-service model.
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A formal scientific assessment of Pennsylvania's multipayer medical home program is under way, reports David K. Kelley, MD, MPA, chief medical officer for the Pennsylvania Department of Public Welfare Office of Medical Assistance Programs.
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Medicaid patients facing serious or life-threatening illnesses incurred $6,900 less in hospital costs if they received palliative care, compared with a similar group of patients who received usual care, according to a new study1. Palliative care recipients also spent less time in intensive care units (ICUs), and were more likely to receive hospice referrals.
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Without the cost savings generated by various programs, including a successful medical home initiative, Pennsylvania Medicaid "would have been in a much worse position than what we're in," says David K. Kelley, MD, MPA, chief medical officer for the Pennsylvania Department of Public Welfare Office of Medical Assistance Programs.
