Archive for October, 2011


States Looking to Cut Medicaid Spending

With supplemental funding from the 2009 federal stimulus law gone, the economy still in free-fall, and Medicaid costs still rising, most states are looking for ways to reduce their Medicaid spending.

According to a new survey conducted by the Kaiser Commission on Medicaid and the Uninsured, nearly every state in the country has implemented at least one policy designed to cut Medicaid costs in the past two years.  Among the more common cuts:  reduced payments to providers; reduced benefits for beneficiaries; new co-pays for beneficiaries; greater use of managed care; and a renewed effort to make greater use of home- and community-based services for recipients who need long-term care.

Read a summary of the survey’s findings and a find a link to the entire Kaiser survey here.…

Medicaid Expansion Under the Affordable Care Act

How many people will the Affordable Care Act add to the nation’s Medicaid rolls?

Prognosticators have suggested that anywhere from 10 million to 25 million people will become newly eligible for Medicaid when the Affordable Care Act’s revised Medicaid eligibility standards take effect in 2014.  Earlier this year, the Congressional Budget Office (CBO) estimated that Medicaid would attract 16 million new enrollees between 2014 and 2019.

Now, researchers from the Harvard School of Public Health have weighed in on the debate.  While they suggest that the number of new Medicaid beneficiaries could range anywhere from 8.5 million to 22.4 million, they believe 13.4 million new people will enroll in the program between 2014 and 2019.

Read about the Harvard study, which also addresses the budgetary implications of Medicaid expansion,  in this article in the journal Health Affairs.…

States Seek New Ways to Manage Health Care Costs

As states continue to struggle with budget woes, they are getting more aggressive, and more ambitious, about finding ways to cut their health care costs – and they aren’t waiting for health care reform to kick in to get started.

Oregon, for example, hopes to introduce a new series of community health centers that would provide more integrated care to their patients.  At first the centers would serve only Medicaid and dually eligible (Medicare and Medicaid) patients, but eventually, state officials hope the clinics will serve public employees and teachers and possibly small businesses as well.  Read about Oregon’s plans in this Stateline report.

Massachusetts is focusing its attention on a narrower group:  chronically ill dual eligibles.  The state hopes to move 115,000 such individuals from its Medicaid fee-for-service program to managed care plans.  Learn more about Massachusetts’s plans in this Wall Street Journal article.

With the federal government encouraging states to find new ways to serve their dual-eligible populations and the federal government, through the Affordable Care Act-created Center for Medicare and Medicaid Innovation (CMMI) providing seed money for such innovation, more states can be expected to begin testing new approaches to serving this population in the …

A Different Approach to Medicare Advantage

Think all Medicare Advantage plans are more or less alike?  One California plan begs to differ.  Read about it in this article in the November 2011 edition of The Atlantic magazine.…

Making Sense of the Affordable Care Act

Cost sharing?  The Medicare Part D prescription drug gap?  Health insurance exchanges?  Medicaid expansion?  Market reforms?  What do these concepts all mean in the context of the Affordable Care Act?

The Robert Wood Johnson Foundation has created a brief series of videos designed to explain these concepts and illustrate the role they play in the implementation of the Affordable Care Act.  View the videos here.…