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The single biggest challenge with health care reform is "the increased resources needed to implement this legislation," says Leslie Clement, administrator of the Department of Health and Welfare's Division of Medicaid. "Idaho is currently experiencing budget deficits. Projections do not indicate that this will change much in the near future."
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The growing cost of long-term care services in Medicaid, which currently accounts for 32% of total Medicaid spending, could double or even triple by 2030, according to a June 2010 report from the Washington, DC-based Deloitte Center for Health Solutions, Medicaid Long-term Care: The Ticking Time Bomb.
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While the Patient Protection and Affordable Care Act offers opportunities to enhance long-term care services in Medicaid, one obvious obstacle is fiscal.
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There is no question that Medicaid programs can use all the legitimate cost-cutting ideas they can get, but Idaho has gone the extra mile.
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Husbands or wives who care for spouses with dementia are six times more likely to develop the memory-impairing condition than those whose spouses don't have it, according to the results of a 12-year study led by Johns Hopkins, Utah State University, and Duke University.
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Community Care of North Carolina, an enhanced Primary Care Case Management (PCCM) program, uses a "population management" approach to manage high-cost Medicaid clients.
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Georgia, like many states, is in the process of collecting data to show the results of its Money Follows the Person (MFP) program. "To date, 305 individuals left the nursing home and returned to the community," reports Alice Hogan, PMP, program director for Waiver Services at the Georgia Department of Community Health's Division of Medicaid, and acting project director for the state's MFP program.
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The option to expand Medicaid coverage to childless adults immediately, instead of waiting until 2014, is one fiscal opportunity for states included in health care reform legislation. In April 2010, Connecticut became the first state to formally seek approval under the new federal law to cover more individuals under Medicaid.
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While state Medicaid programs have projected the expected number of individuals coming in to the program in 2014 as a result of health care reform, it's less understood who these individuals will be. Are they a relatively healthy group, or are do they have complex, costly health care needs?