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Imagine if your family car came in separate parts so that you had to decide which parts were needed, find where you could buy them, and then assemble them yourself. With no overall design for the car and no quality management to make sure the parts fit and determine how well the car is working, what kind of a vehicle do you think youd have and how would you determine how cost-effective it was? That analogy impressed a number of people in Maine as they developed their states response to the U.S. Supreme Court decision in the Olmstead case involving state efforts to provide services to the disabled in a coordinated, least-restrictive environment.
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Hoping to head off suggestions in some financially pressed states that Medicaid should abandon managed care and return to a fee-for-service payment mechanism, the Washington, DC-based Association for Health Care Affiliated Health Plans is publicizing a study it funded that it says demonstrates managed care does a better job of caring for Medicaid beneficiaries than traditional fee for service does.
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Medicaid shortfalls plague Illinois; Medicaid to cut dental benefits for WA adults; Medicaid may force elderly to sell homes; Doctors applaud repeal of Medicaid pay cuts; 1,800 could lose Medicaid benefits; Medicaid coverage for 10,000 in state is back on hold
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In a ground-breaking analysis, the Institute of Medicine has calculated what the United States loses each year due to poorer health and early deaths among the 41 million uninsured people in the United States.
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State purchasers, policy-makers, plan executives, and consumers should not dismiss public sector managed care or assume it has arrived at the end of its cycle. Thats the conclusion of a working paper published by the Lawrenceville, NJ-based Center for Health Care Strategies on what lies ahead for Medicaid behavioral managed care.
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While states budget problems are limiting interest in attracting new people to the Medicaid program, that situation will surely change at some point, and then states will be looking for ways to reach out to those eligible for Medicare. A study by Mathematica Policy Research senior health researcher Suzanne Felt-Lisk says one model that states can use to improve outreach to Medicare beneficiaries is the SCHIP program and its intense focus on enrolling all who are eligible for it.
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Accelerating health care spending. A steep and lengthy drop in revenues. These twin evils are at the heart of the states ongoing fiscal crisis, says the National Governors Association.
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The goal of an initiative to support new training, technical assistance, and grant-making for up to six states interested in developing quality-focused pharmacy management strategies, which will start this fall, is to find feasible solutions that improve quality, reduce costs, and are amendable to all stakeholders.
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A by-product of efforts to increase patient empowerment and involvement in their own care is the use of quality-of-life assessments in evaluations of state Medicaid programs.
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To alleviate the problem of social admissions from the emergency department, Northeast Medical Center in Concord, NC, established an ED case management staff and made arrangement with local assisted living facilities to admit patients directly from the ED.
