State Health Watch Archives – February 1, 2010
February 1, 2010
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More cuts coming for Medicaid? Utilization management can't be ignored
Medicaid programs may never have had as much reason to redouble their utilization review efforts, in order to be sure funds are not being spent inappropriately, as they do right now. -
Fiscal Fitness: How States Cope: Washington Medicaid facing additional cuts: What's next for recipients?
After last year's round of budget cuts, Washington Medicaid seemingly exhausted all opportunities to achieve savings through purchasing initiatives. -
Budgetary challenges may limit ability to recoup Medicaid overpayments
In fiscal year 2008, Alabama's Program Integrity Division's Pharmacy Audit unit reviewed 143 medical providers and 629 pharmacies to assure proper claim payment and recovery of identified overpayments. -
Chronic care project targets most expensive LTC clients
Washington's Chronic Care Management Project targets the most medically expensive, high-risk Medicaid clients in its long-term care system. It has lowered mortality and improved the health of clients with chronic conditions such as diabetes, heart disease, and musculoskeletal diseases. -
Surprising findings on expenditures for Medicaid 'Buy-In' participants
On the one hand, expenditures for Medicaid Buy-In participants, who pay monthly premiums, more than doubled from $887 million to $1.9 billion between 2002 and 2005, as did program enrollment. On the other hand, this group was found to be less expensive than other adult disabled Medicaid enrollees, with lower average Medicaid expenditures. -
Changing client behavior is top challenge for decreasing ED use
There is no question that decreasing inappropriate use of the emergency department for Medicaid patients can save significant costs, but getting results is a daunting challenge.