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New York state's Medicaid Visual Data Mining System allows state officials and policy makers to track the results of savings initiatives in real time, via a spending tracking website, according to Morris Peters, a spokesperson for the Division of Budget. (To view the site, go to http://www.health.state.ny.us/health_care/medicaid/regulations/global_cap/.)
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Washington Medicaid's plan to limit non-urgent ER visits to three a year is being watched "with great interest," says Randall Best, MD, JD, chief medical officer for North Carolina's Division of Medical Assistance. "It's a hot topic in pretty much all the states right now."
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Budget reductions for the 2011-2013 biennium in Washington state include a legislatively mandated limit on non-emergency visits to hospital ERs, reports Jeffery Thompson, MD, MPH, chief medical officer of Washington's Medicaid program.
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Delaware Medicaid's long-term care population is still primarily fee-for-service, and this population is very high-cost because many individuals are in facility-based care, says Rita M. Landgraf, secretary of Delaware's Department of Health and Social Services. In April 2012, this group will switch to a managed care organization, she reports.
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When Delaware Medicaid attempted to implement co-pays, "we didn't get very far with our legislative branch on that," reports Rita M. Landgraf, secretary of Delaware's Department of Health and Social Services.
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California has appealed a 9th U.S. Circuit Court of Appeals decision stopping a 10% provider rate reduction from going forward, with an anticipated decision by the Supreme Court by spring 2012, notes Stan Rosenstein, MPA, principal advisor at Health Management Associates in Sacramento, CA, and former California Medicaid director.
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An estimated 23 million non-elderly Americans will remain uninsured after 2014, including 15 million eligible for Medicaid coverage, according to a March 2011 Congressional Budget Office report.
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Interestingly, the Patient Protection and Affordable Care Act (PPACA) takes some steps toward federalization of Medicaid from both a philosophical and a financial perspective, says Nicole Huberfeld, an associate professor at the University of Kentucky's College of Law in Lexington.
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Six state Medicaid programs are currently coming up with strategies to maximize the benefits of the mandated primary care rate increase, as participants in Leveraging the Medicaid Primary Care Rate Increase, an initiative from the Hamilton, NJ-based Center for Health Care Strategies (CHCS).
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Medicaid beneficiaries who receive care for mental health or substance abuse have greater physical health needs and higher overall costs than other beneficiaries, indicating the need for better integration of physical and behavioral health care under Medicaid, according to Providing Care to Medicaid Beneficiaries with Behavioral Health Conditions: Challenges for New York, a February 2011 report from the Medicaid Institute at United Hospital Fund in New York City.
