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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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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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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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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.
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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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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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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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For infants and young children with urinary tract infection (UTI) seen in the emergency department, a simple ultrasound examination might avoid the need for more complex X-ray tests, reports a study in a recent issue of The Pediatric Infectious Disease Journal.
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The financial demands on the current healthcare system puts more pressure on case managers to prepare patients for hospital discharge, ensure that they receive care in an appropriate venue, and/or support the patients in managing their chronic illnesses, says Teri Treiger, RN-C, MA, CCM, CCP, a case management consultant based in Holbrook, MA, and past president of the Case Management Society of America (CMSA), with headquarters in Little Rock, AR.
