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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.
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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.
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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.
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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.
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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.
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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).
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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.
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It is expected that metrics will be available so that the contributions of case management are quantified, as outlined by Toni Cesta, PhD, RN, FAAN, senior vice president, Lutheran Medical Center, Brooklyn, NY, in her April 2011 Case Management Insider article "You're only as good as yesterday's discharges Strategies to demonstrate case management's value."
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The devil is in the details when it comes to convening a successful interdisciplinary meeting.
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To maintain stability and effectiveness in meetings, the following steps should be considered.
