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While South Carolina's governor has given a directive to find ways to spend money more productively in Medicaid, says Tony Keck, the state's Medicaid director, she has also given the directive to present credible alternatives to allow the state to opt out of federal health care reform.
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Plans' lack of experience is one concern as states move their Aged/Blind/Disabled (ABD) and Supplemental Security Income (SSI) populations into Medicaid managed care, according to James Verdier, a senior fellow in the Washington, DC, office of Mathematica Policy Research, a nonpartisan research firm.
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When West Virginia experimented with penalty-based systems that withdrew some Medicaid benefits if beneficiaries didn't comply with certain behaviors, focus groups were done to gauge the public's reaction to this.
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If recent state efforts to reform Medicaid, including Rhode Island's and Texas's, prove to be successful, we are likely to see similar approaches in other states, says Elizabeth Weeks Leonard, JD, associate professor of law at the University of Georgia in Athens.
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Ohio Medicaid got by with policy changes and rate reductions for the past two years, says Medicaid director John McCarthy, but future efforts are going to focus on better management of high-cost clients, including dual eligibles.
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Alabama Medicaid hasn't made any changes to its copays, which are $3 for outpatient hospital visits and exempted for emergencies, nursing home patients, pregnant women, children or patients receiving family planning services, and doesn't intend to do so, according to the state's Medicaid medical director, Robert Moon, MD.
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Family planning services have a special status under Medicaid, notes Judith Solomon, co-director of Health Policy at the Center on Budget and Policy Priorities in Washington, DC.
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Sixty percent of the 900,000 Oklahomans who were provided healthcare in fiscal year 2010 by the Oklahoma Health Care Authority received care from the SoonerCare Choice program, which transitioned to a Patient Centered Medical Home (PCMH) model in January 2009.
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Ohio Medicaid managed to keep optional services off the table throughout the recession, despite having a "fundamentally changed" economy in the state, according to Medicaid director John McCarthy.
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The benefits of e-prescribing to patient care are often touted, but the reality is that physician practices often find some features cumbersome and unreliable, according to a new study from the Center for Studying Health System Change (HSC) in Washington, DC.
