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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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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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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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For Penny Black, the director of home and community services with the Washington Department of Social and Health Services, the GAO report, which is raising questions about quality assurance for Medicaid beneficiaries services by home and community service waivers, is worrisome for its potential impact on the programs, especially when political leaders say future waivers should not be approved until the quality issues are addressed.
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According to a General Accounting Office report, the Centers for Medicare & Medicaid Services should ensure that state quality assurance efforts adequately protect the health and welfare of Medicaid beneficiaries covered under home and community-based service waivers.
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The American Industrial Hygiene Association (AIHA) has issued a position statement on H1N1 pandemic influenza A that endorses and reiterates the key findings of an Institute of Medicine panel that recommended N95 respirators for health care workers. Key points stressed by AIHA include:
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Over the past 12 months, Ohio Medicaid has seen a 9% increase in enrollment, totaling 168,000 additional individuals on the program. Interestingly, though, 80% of that growth has been in the Healthy Families program, which covers parents, pregnant women, and children at low income levels.
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When Michael P. Starkowski, commissioner of Connecti- cut's Department of Social Services, gave a recent presentation, a woman in a wheelchair approached him during a coffee break. She asked whether he had anything to do with Money Follows the Person (MFP), a Medicaid initiative that helps people transition from institutions to community living.
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Oklahoma's Medicaid director, Lynn Mitchell, MD, says as of January 2009, the state's primary care case management (PCCM) program, called SoonerCare Choice, in which 423,000 Oklahomans participate, had "further embraced the patient-centered medical home principle, and we did that as a request from our providers. We feel that this will take even a further benefit to our members."
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A small but committed number of state Medicaid programs are setting out to enhance their primary care case management programs (PCCM) that link beneficiaries to primary care providers (PCPs) and pay providers for a core set of care management activities.
