State Health Watch Archives – July 1, 2010
July 1, 2010
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Health reform means major overhaul of Medicaid's eligibility systems
Providing seamless enrollment procedures is still a work in progress for state Medicaid programs under the current eligibility system, but doing so under health care reform is a health information technology (HIT) challenge of epic proportions. -
Nevada Medicaid faces "cognitive fiscal dissonance"
With Medicaid enrollment increases of 3,000 a month showing no signs of slowing, having already made virtually all possible cuts to the program, and facing a projected $3 billion shortfall in the state, Charles Duarte, administrator for Nevada's Division of Health Care Financing and Policy, describes the process of planning for an estimated 150,000 more people coming onto the program as one of "cognitive fiscal dissonance." -
California's Medi-Cal modernizing enrollment
California's Medi-Cal Eligibility System (MEDS) will need to be completely replaced to accommodate the changes necessary to implement health care reform, according to Vivian Auble, a senior consultant at Health Management Associates in Sacramento and former chief of California's Medi-Cal eligibility division. This could cost up to $250 million, not including costs to establish and operate the state insurance exchange, or to develop a new application and enrollment portal. -
Medicaid patients far more likely to be readmitted
One of every 10 adult Medicaid patients hospitalized in 2007 for a medical condition other than childbirth had to be readmitted at least once within 30 days, according to an April 2010 report from the Rockville, MD-based Agency for Healthcare Research and Quality (AHRQ), All-Cause Hospital Readmission Rates among Non-Elderly Medicaid Patients, 2007. The report uses statistics generated from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases for 10 states. -
Colorado Medicaid set to save millions on readmissions
Every year, Colorado Medicaid spends $20 million on hospital readmissions that occur within 30 days. This fact was brought to light as a result of a comprehensive data analysis done a year ago. It is one of the reasons that readmissions have become a key priority for the program. -
Different populations require different approaches
The Medicaid and Medicare populations call for two very different strategies for preventing hospital readmissions, according to Michael Birnbaum, director of policy at United Hospital Fund's Medicaid Institute in New York City. -
Nursing facility care: duals shifted away from Medicaid?
Over half of nursing facility residents are dual-eligibles. This means they must contend with a system of care that often is not well-coordinated or efficient.