Unbiased Analysis of Today's Healthcare Issues
Fraudulent providers can rob taxpayers of money due to Medicaid beneficiaries. Fraudulent offenses include: billing Medicaid for services provided to patients ineligible for Medicaid; billing for services not rendered; upcoding (i.e., charging for more expensive services or equipment that the patient received); providing inappropriate, risky or unncessrary treatments; requesting reimubrsement for care provided by unlicensed…
In the third post using information from The Politics of Medicaid series, we will discuss how States often try to reduce Medicaid spending. From a fiscal point of few, Medicaid spending is often attractive since it is accompanied by matching federal dollars. On the other hand, Medicaid trails only elementary and secondary education in terms…
In the 1990s, State Medicaid programs turned to Managed Care Organizations (MCOs) to reduce costs. States such as Florida, Indiana, Kentucky, Louisiana, Missouri, Ohio, South Carolina and Texas attempted to turn over their entire Medicaid programs to MCOs through waivers. For instance, in 2007 MO HealthNet mandated managed care for all participants by 2013. Some of the larger…
“If you’ve seen one Medicaid program, you’ve seen one Medicaid program.” This week, I will review some of the findings from a wonderful book titled The Politics of Medicaid. Author Laura Katz Olson writes a well-researched book that evaluates Medicaid from the points of view of its various stakeholders including beneficiaries, providers (esp., physicians and…
In early 2008, Oregon expanded it’s Medicaid eligibility. To take advantage of these new benefits, 85,000 individuals signed up. Oregon’s budget, however, only had enough money to fund Medicaid coverage for 30,000. In a researcher’s dream case, Oregon decided to select the 30,000 eligible to apply for coverage using random assignment. Because this policy in…
One of President Obama’s biggest initiatives as part of health reform was to reduce fraud, waste and abuse in Medicare and Medicaid. Today, I will discuss how the Medicaid program fights fraud at the federal level. Because Medicaid is state-run, the States have typically been the ones responsible for ensuring efficient Medicaid operations. However, the…
“Across the nation, sizeable and forceful groups–a Medicaid medical industrial complex–support welfare medicine, many of them becoming entirely or partially dependent on its funding for their financial viability. Their reliance on the low-income health program puts them at risk of adverse political decisions, but also drives them to exert disproportionate influence over policymakers. Vested interests–professionals,…
Tyler Cowen thinks that one way to reduce the fiscal burden on States is to move Medicaid to the Feds. Wisconsin may be taking a first step in that direction. Wisconsin Governor Jim Doyle, having to make $400 million in Medicaid cuts, left these cuts up to Federal Medicaid officials. Newsweek reports that “The fixes,…
How will health reform affect state health care costs? Will reform bankrupt states as some Republicans say? Or will costs be negligible, as Democrats claims? According to a study by Holahan and Dorn (2010) the answer is somewhere in the middle. Most of the additional costs will come from expanding Medicaid to newly eligible population,…
In Virginia, there are over one million people age 60 and older and over 90,000 Virginians age 85 and older. These figures will only grow in the upcoming decades. Thus will put increasing strain on public programs and will require service providers to reorient medical care toward providing continued, high-quality long term care services. Long…