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Nearly 80% of 13,069 uninsured patients in the ERs of four San Diego hospitals over an 11-month period were eligible for some form of government insurance, yet weren't enrolled, according to a Point-of-Service ER Survey conducted by the San Jose, CA-based Foundation for Health Coverage Education (FHCE).
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Most states can come out ahead financially under health care reform, according to Stan Dorn, a senior fellow at the Urban Institute in Washington, DC, noting that a December 2010 Urban Institute study found that states would see net budget savings of between $40.6 billion and $131.9 billion from 2014 to 2019 because of the Affordable Care Act (ACA).
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Individuals with Medicaid coverage were 70% more likely to have a regular medical office to obtain basic care, 55% more likely to have a personal doctor, and obtained more preventive care than an uninsured group, according to a new study.
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Some states are contemplating asking the federal government for a "waiver" of the standard Medicaid requirements modeled after Rhode Island's, which was implemented in 2009, says Jesse Cross-Call, a policy associate on the Health Policy team at the Center on Budget and Policy Priorities in Washington, DC.
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The approval of a Bridge waiver in January 2011 "rescued" Washington state's Basic Health plan, according to Doug Porter, the state's Medicaid director, and should give the state a preview of Medicaid expansion. "We're now drawing down federal matching funds for a program that was previously all state funded," he says.
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Although governors' proposed budgets for fiscal 2012 showed a 2.9% decline in Medicaid spending, state funds going to the program are predicted to increase by 18.6%, according to a spring 2011 report from the National Governors Association and the National Association of State Budget Officers.
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Washington Medicaid first tried moving its high-cost Supplemental Security Income (SSI) population into managed care back in the 1990s, but that effort was a failure, according to Doug Porter, the state's Medicaid director.
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The Affordable Care Act (ACA) will cost states $118 billion through 2023, according to the March 2011 Joint Congressional Committee report, Medicaid Expansion in the New Health Law: Costs to the States, while a March 2011 analysis from the Congressional Budget Office (CBO) estimated a cost of $60 billion through 2021.
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Medicaid directors have been concerned that they would have to set up duplicative or "shadow" eligibility systems to distinguish between current eligibles and new eligibles under the Affordable Care Act (ACA), according to Tricia Brooks, a senior fellow at the Georgetown University Center for Children and Families in Washington, DC.
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No matter what model of accountable care organization (ACO) the Centers for Medicare and Medicaid Services (CMS) settles on, case managers are sure to be key players as providers focus on managing care efficiently and effectively across the continuum.
