State Health Watch 2011-07-01

Will new initiatives be enough to solve dual eligibles problem?

Dual eligibles account for 15% to 20% of Medicaid enrollment and almost 40% of Medicaid spending, notes Leslie Hendrickson, PhD, principal of Hendrickson Development, an East Windsor, NJ-based consulting group that helps to develop and strengthen long-term care programs, and former assistant commissioner in the New Jersey Department of Health and Social Services.

SC finds rate cuts necessary to protect Medicaid's optional services

South Carolina Medicaid is taking a variety of innovative approaches to reduce waste in the program, reports Tony Keck, the state's Medicaid director. Optional services including adult vision, adult dental, and adult podiatry have already been eliminated, he says, with some exceptions based on Centers for Medicare & Medicaid Services (CMS) requirements.

Medi-Cal: Provider rate cuts are necessary

California's fiscal year 2008-2009 budget enacted several 10% Medi-Cal provider payment reductions, according to Toby Douglas, director of the California Department of Health Care Services and the state's Medi-Cal director.

Build primary care capacity now for Medicaid's new eligibles, expert says

When you consider the newly eligible population coming onto your state's Medicaid program in 2014, remember that "those 32 million people out there are already being seen somewhere. They are being seen by a range of safety net providers," says Georges C. Benjamin, MD, FACP, FNAPA, FACEP(E), executive director of the American Public Health Association in Washington, DC.

NPs, PAs are essential to build primary care access

Ensuring access to primary care in Medicaid is going to take a "multi-pronged strategy," according to Julia Paradise, MSPH, an associate director of the Kaiser Family Foundation's Kaiser Commission on Medicaid and the Uninsured and lead author of the organization's March 2011 brief, Improving Access to Adult Primary Care in Medicaid.

Medicaid may be more popular than you realize

"Increased support for primary care providers who participate in Medicaid is one lever for securing more capacity in the program."

States making smart use of technology with enrollment

States have achieved substantial progress in streamlining Medicaid enrollment and renewal processes for children, but have achieved less progress in this area for adults, according to Samantha Artiga, MHSA, a principal policy analyst at Kaiser Family Foundation (KFF) in Menlo Park, CA.

Data on "young" medical homes is still new, but trends looking good

There isn't a lot of data on the cost savings of state medical home initiatives because the state pilots and demonstrations are still new, according to Mary Takach, MPH, RN, the lead researcher on the Washington, DC-based National Academy for State Health Policy's Medical Homes II Consortium project.

Medical homes may give better quality of life to chronically ill

States can "drastically improve" the health of their sickest Medicaid beneficiaries by taking advantage of the new option in the Patient Protection and Affordable Care Act to offer "health homes" to enrollees with chronic conditions, according to Renée Markus Hodin, director of the Integrated Care Advocacy Project at Community Catalyst in Boston, MA.

Don't allow Medicaid program's budget impact to be overstated

The impact of Medicaid on state budgets is often overstated, according to a March 2011 report from the Georgetown University Health Policy Institute's Center for Children and Families in Washington, DC.

Medicaid payment reforms are desired, but states face obstacles

States are poised to take advantage of the payment reform approaches outlined by the Center for Medicare and Medicaid Innovation (CMMI) established by the Centers for Medicare & Medicaid Services (CMS), says Anne Gauthier, a senior fellow at the Washington, DC-based National Academy for State Health Policy (NASHP).

Medicaid provider rate cuts on the table? It could be illegal

Rates paid to Medicaid providers are "both a provider and a beneficiary issue," according to Byron J. Gross, BA, JD, an attorney in the Los Angeles office of the National Health Law Program.

State Health Watch Archives – July 1, 2011

July 1, 2011