State Health Watch 2010-04-01

Nonpayment for preventable conditions expected to drive QI in Medicaid

Nonpayment policies for preventable adverse events are valuable to motivate quality improvement efforts, and payment should not be expected for a bad outcome that is unnecessary or avoidable. These are two things about which most providers, payers, and the public can agree.

Fiscal Fitness: How States Cope: Unique nonpayment approach could save Maryland Medicaid $89 million annually

Instead of denying payment outright for preventable conditions as other states do, Maryland is taking a unique approach by instead adjusting payments. The goal is to reduce the statewide averages of these conditions, with the bar raised from year to year, and significant cost savings are expected.

Tap underutilized resources for care coordination of children

State Medicaid programs are taking various approaches to promote care coordination for young children, but few utilize existing maternal child health hotlines or web-based referral strategies.

Hawaii Medicaid streamlines its referral process for children

Providing case management and care coordination for children is not merely an option for providers in Hawaii's Medicaid program; it is a requirement in their contracts. The agency recently began monitoring how many children are actually receiving these services.

Better outreach is key factor in increasing coverage of kids

In sharp contrast to adults, the number of uninsured children declined by 800,000 during the first 12 months of the recession, from December 2007 through December 2008, according to a December 2009 report from the Washington, DC-based Kaiser Commission on Medicaid and the Uninsured, "Protecting Children During the Recession: Spotlight on State Health Coverage Efforts." Outreach efforts by state Medicaid programs are a big reason why.

Washington Medicaid uses multifaceted outreach approach

Even during the recession, Washington state has maintained its multifaceted approach to outreach.

Providers may or may not meet 'meaningful-use' criteria

A Medicaid provider may have spent a great deal of time and money to adopt electronic health record (EHR) technology, but can he or she demonstrate that this tool meets the Centers for Medicare & Medicaid Services (CMS) criteria for "meaningful use"? If not, that provider won't qualify for federal incentives for EHR, enacted under the American Recovery and Reinvestment Act of 2009.

Medicaid preparing for HIT investments available through ARRA

As federal funds are beginning to flow to state Medicaid programs for Health Information Technology (HIT) planning, there is an unprecedented opportunity for care system transformation. While it's not a "given" that all states will apply for the funding, they are exploring a variety of options to maximize their access.

State Health Watch Archives – April 1, 2010

April 1, 2010