How to cut State Medicaid Costs

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…

Do Medicaid Managed Care Organizations Save Money?

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…

Medicaid Overview

“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…

Medicaid Expansion in Oregon

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…

The Medicaid Integrity Program

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…

The Medicaid Medical Industrial Complex

“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,…

Medicaid’s humble beginings

Although Medicaid is currently one of the largest programs in any state’s budget, Congress enacted this welfare health insurance scheme as almost an afterthought. Consider the news coverage for Medicaid at the time.  According to the chart below, the New York Times didn’t even mention Medicaid an any article in 1965 and Medicaid was mentioned…

Center for Medicare and Medicaid Innovation

Medicare and Innovation in the same sentence?  Yes indeed. As part of Health Reform [i.e, Patient Protection and Affordable Care Act (PPACA)], the government mandated the creation of the Center for Medicare and Medicaid Innovation (CMI). What does CMI do?  “The stated purpose of the CMI is to test innovative payment and service delivery models…