Create a new Medicaid state plan option to permit Medicaid enrollees with at least two chronic conditions, one condition and risk of developing another, or at least one serious and persistent mental health condition to designate a provider as a health home. Provide states taking up the option with 90% FMAP for two years for health home related services including care management, care coordination and health promotion.
Create the State Balancing Incentive Program in Medicaid to provide enhanced federal matching payments to increase non-institutionally based long-term care services.
“Already, Medicaid is the second largest item on the average state budget at 21% (education is first at 22%). But according to the Centers for Medicare and Medicaid Services (CMS) that is all about to change very soon thanks to Obamacare. Remember, more than half of the health care coverage expansion under Obamacare is attained by placing Americans on Medicaid. CMS projects that state and local spending on Medicaid will increase 41.4% between 2010 and 2011. 41%!!!”
ObamaCare expands Medicaid by 16 million new enrollees, but current beneficiaries get poor quality care and face long wait times to find doctors. Providers frequently refuse to treat Medicaid patients because the reimbursement rates are so low. “Once the new law is fully in effect, roughly one in five Americans will carry a Medicaid card. But the combination of rapid beneficiary growth with benefit and provider cuts threatens to render their cards useless.”
“Incentives count, it turns out. People will do what they are paid to do. Doctors paid to implant stents will implant stents.
Doctors paid to think long and hard about whether a stent is necessary may be less eager surgeons. This story will not be the last in this genre as incentives settle into place under government-run health care.”
“While we applaud the Chairs’ initiative and efforts to reduce future federal outlays, we feel their proposals ultimately fail to provide an adequate plan for the fiscal future, especially for the unsustainable rise in federal health care costs. We believe that the proposals can contribute to the ongoing budget debate, but are not a roadmap. To help inform the healthcare budget discussion, we outline below the good, the bad, and the ugly policy prescriptions in the co-chairs proposal.”
CMS Administrator Don Berwick testified at his first and only Senate hearing for such a brief time, that he was unable to be thoroughly questioned. “Sen. Orrin Hatch (R-Utah) called the hearing ‘pathetic’ and said the time constraints made any real questioning difficult. ‘It’s like asking us to drain the Pacific Ocean with a thimble,’ he said. ‘We ought to have time to ask the most important man in healthcare sufficient questions.'”
“Dr. Donald M. Berwick, the new chief of Medicare and Medicaid, survived his first confrontation with Republican lawmakers on Wednesday, brushing aside criticism of the new health care law and denouncing efforts to repeal it.”
“The Patient Protection and Affordable Care Act (PPACA) will place unprecedented fiscal pressure on states, several of which are already suffering from multibillion-dollar budget deficits. Although many of the law’s most costly requirements will not take effect until 2014, some states are bracing for billions in new spending, while others have already started to take costly steps toward implementing the new law.”
The state of Texas is considering ending their Medicaid program entirely rather than dealing with new Medicaid costs from ObamaCare. The law’s “maintenance of effort” provisions prevent Texas from modifying eligibility requirements or implementing most other cost-saving measures. This could require new federal spending to offset the reduction.