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State Health Watch Archives – May 1, 2011

May 1, 2011

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  • The battle is on to control soaring costs of Medicaid's chronically ill

    Evidence is mounting that a very small group of high-cost chronically ill clients accounts for the lion's share of costs in Medicaid programs.
  • DE Medicaid looks to disease management for long-term savings

    Not surprisingly, the biggest current fiscal challenge for Delaware Medicaid is the dramatic increase in enrollment over the past two years, according to Rita M. Landgraf, secretary of the state's Department of Health and Social Services.
  • Medicaid takes the lead in creation of Health Exchange

    Delaware's Medicaid agency has been designated as the lead agency for the purpose of administering federal funds for planning the state's health benefit exchange, reports Rita M. Landgraf, secretary of the state's Department of Health and Social Services.
  • Iowa program targets the 5% most costly Medicaid clients

    Iowa Medicaid's disease management program, implemented in July 2010, has a focus that's a "little bit unique," according to Leslie Schechtman, DO, medical director of Iowa Medicaid Enterprise, Member Services. "We used a stratification methodology."
  • New Medicaid populations being integrated into managed care

    For Medicaid programs that have good relationships with managed care contractors already in place, it's a "natural development" to add the population of seniors and people with disabilities, says Alice R. Lind, RN, MPH, senior clinical officer at the Center for Health Care Strategies (CHCS) in Hamilton, NJ. "The timing is right now, because budgets are tight."
  • Medicaid's interest in health homes remains high

    Health homes are a model of care that many states are very interested in moving toward, according to Julia Paradise, associate director of the Kaiser Family Foundation's Kaiser Commission on Medicaid and the Uninsured (KCMU). Ms. Paradise is author of the January 2011 brief, Medicaid's New "Health Home" Option.
  • Medicaid MC moves from its "gatekeeper" reputation

    In previous years, there was a widespread perception that the reason managed care was cost-effective was that services were restricted, according to Alice R. Lind, RN, MPH, senior clinical officer at the Center for Health Care Strategies (CHCS) in Hamilton, NJ. This was a largely undeserved reputation, she says, but it worked against managed care expansion.
  • HCBS poised to expand: Wait lists reveal large unmet need

    States have some good fiscal opportunities to expand home- and community-based services (HCBS) in the Patient Protection and Affordable Care Act (PPACA), according to Charlene Harrington, RN, PhD, FAAN, director of the University of CaliforniaSan Francisco's National Center for Personal Assistance Services.
  • Churning expected to worsen after the Medicaid expansion

    The problem of "churning," when individuals cycle on and off Medicaid rolls, is expected to increase after the Medicaid expansion, according to a study published in the February 2011 issue of Health Affairs, "Issues In Health Reform: How Changes In Eligibility May Move Millions Back And Forth Between Medicaid And Insurance Exchanges."
  • Medicaid looks to payment reform to save money and improve care

    States are pursuing a number of reform models for changing the way health care providers are paid, reports Deborah Bachrach, special counsel at Manatt, Phelps & Phillips, a health law and consulting firm in New York City, and former New York Medicaid director
  • Medicaid's early payment reform efforts appear "very promising"

    Many of the payment reform approaches outlined by the Center for Medicare and Medicaid Innovation (CMMI) established by The Centers for Medicare & Medicaid Services are initiatives that states have pursued for some time, such as medical homes, says Neva Kaye, managing director for health system performance at the Washington, DC-based National Academy for State Health Policy (NASHP).