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CMS Shares Vision for Medicaid

Medicaid is about to undergo major changes, CMS administrator Seema Verma outlined in a news release yesterday and in a speech to state Medicaid directors.
According to the news release, those changes include:

  • re-establishing a state-federal partnership that Verma believes has become too much federal and not enough state
  • giving states greater freedom to innovate
  • offering new guidelines for how states can align their individual programs with federal Medicaid objectives
  • new guidance on section 1115 waivers
  • longer section 1115 waivers with simpler review processes
  • CMS willingness to consider proposals to impose work requirements on Medicaid beneficiaries
  • Medicaid and CHIP “scorecards” that track and publish state and federal Medicaid and CHIP outcomes

Pennsylvania safety-net hospitals serve more Medicaid patients than the typical hospital and would therefore be affected more by any major changes in how Medicaid operates.
Go here to see CMS administrator Verma’s full new release and to find links to relevant documents, web sites, and Ms. Verma’s speech about the changes.  Go here to read a Washington Post report on Ms. Verma’s speech and here to see a Kaiser Health News report.

2017-11-08T06:00:43+00:00November 8th, 2017|Federal Medicaid issues|Comments Off on CMS Shares Vision for Medicaid

Changing Medicaid

House Chamber of the State HouseWith policy-makers in Washington considering some changes, and possibly major changes, in the state/federal Medicaid partnership, the Health Affairs Blog has taken a look at some of the options those policy-makers might consider.
Among them are:

  • giving states greater flexibility in the design and implementation of their own Medicaid programs
  • requiring cost-sharing by some or all beneficiaries, such as through premiums and co-payments
  • limiting benefits
  • employing incentives to encourage healthy behaviors

The article also considers the manner in which individuals enroll in Medicaid and how that has evolved over the years.
Because Pennsylvania’s safety-net hospitals care for so many low-income and Medicaid patients, they could be affected by any major federal Medicaid policy changes far more than the typical Pennsylvania hospital.
Learn more about some of the options Congress will have as it looks at possible Medicaid reform in the Health Affairs Blog article “The Future Of Medicaid: When Improving Upon The Wheel, Start With Something Round,” which can be found here.

2017-02-16T06:00:00+00:00February 16th, 2017|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off on Changing Medicaid

A Look at Medicaid’s Immediate Future

With a new president taking office in January who vows to repeal and replace the Affordable Care Act, it is not clear what will happen to Medicaid, which currently covers 73 million Americans.
reform-flagA new paper from the Kaiser Family Foundation looks at some of the major questions that will arise in the coming months, including:

  • How would ACA repeal affect Medicaid?
  • What would changes in the financing structure mean for Medicaid?
  • How could Medicaid be changed through administrative actions?

For this and more, go here to see the Kaiser paper “Key Medicaid Questions Post-Election.”

2016-12-08T09:21:04+00:00December 8th, 2016|Affordable Care Act|Comments Off on A Look at Medicaid’s Immediate Future

Congressional Task Force Considers Medicaid Reforms

A House Energy and Commerce Committee group is looking at potential Medicaid reforms for 2017.
The task force, consisting entirely of Republican members, was created late last year to “… strengthen and sustain the critical program for the nation’s most vulnerable citizens.”
energy and commerceAt a recent event at George Mason University, task force chairman Brett Guthrie (R-KY), cited continued high Medicaid spending as a reason to consider reform and noted that the degree to which the task force could tackle Medicaid in 2017 would depend on which party occupies the White House and controls Congress. He suggested that the task force would look for ways to prevent people from needing to choose between getting jobs and keeping health insurance. Among the potential legislative vehicles for reform, Guthrie said, are reauthorization of the Children’s Health Insurance Program and Medicare extenders.
Because they serve so many Medicaid and low-income patients, the task force’s deliberations will be of particular interest to Pennsylvania’s safety-net hospitals.
Learn more about the House Energy and Commerce Committee’s Medicaid Task Force here and about Rep. Guthrie’s remarks at the George Mason University forum here.

2016-05-13T06:00:47+00:00May 13th, 2016|Uncategorized|Comments Off on Congressional Task Force Considers Medicaid Reforms

Chairmen Seek Ideas for Improving Medicaid

The chairmen of four key congressional committees have written to the Medicaid and CHIP Payment and Access Commission (MACPAC) seeking “assistance in developing policy options to ensure the sustainability of the Medicaid program so it can continue to provide essential coverage and services to vulnerable populations.”
The letter, signed by the chairmen of the Senate Finance Committee, Senate Committee on Health, Education, Labor, and Pensions, the House Energy and Commerce Committee, and the Energy and Commerce Committee’s Health Subcommittee, asks MACPAC to “analyze and evaluate” financing reforms to reduce government spending; past reform proposals; ways to give states greater flexibility; options for Medicaid block grants; and other potential changes.
See the letter here.

2015-05-06T06:00:17+00:00May 6th, 2015|Uncategorized|Comments Off on Chairmen Seek Ideas for Improving Medicaid

How States View Medicaid Reform

What are states looking for from “Medicaid reform”?
How do they evaluate the prospects of reform proposals – and how do they evaluate reforms that have been implemented?
Doctor listening to patientAcross the country, states are pursuing Medicaid reform through section 1115 waivers, Delivery System Reform Incentive Payment Programs (DSRIP), the State Innovation Models (SIM) Initiative, and other means.  As they do, they must decide what innovations to pursue and then make decisions about whether those they have chosen have achieved their objectives and produced genuine payment and delivery system reform, improved outcomes, and laid a foundation for further improvement.
Many of these decisions are made by state Medicaid directors, and now, the National Association of Medicaid Directors has published a paper offering its perspective on Medicaid reform:  what it is, what it looks like, and how they will approach it.  See its paper Perspectives on Innovation here.

2015-04-03T06:00:35+00:00April 3rd, 2015|Pennsylvania Medicaid policy|Comments Off on How States View Medicaid Reform
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