To make up for dramatic budget shortfalls, states have been forced to make various cost-cutting measures to state Medicaid programs, drawing intense ire from healthcare providers across the country. Here are seven points on Medicaid cost containment trends, based on data from the Kaiser Family Foundation, Kaiser State Health Facts and previous Becker's Hospital Review news coverage.
1. One of the most notable trends related to Medicaid cost containment looks to be changes to provider payments under state Medicaid programs. By the end of fiscal year 2012, 45 states and Washington, D.C., will have restricted provider payments. The five states that have not include Wisconsin, West Virginia, North Dakota, Iowa and Alaska.
2. Three states — Hawaii, Connecticut and Arizona — enacted cuts to eligibility for Medicaid by fiscal year 2012. This may involve changes to eligibility standards, application and renewal process or premiums. Other actions restricting eligibility include freezing enrollment. Illinois was the only state so far to have made changes to the application and renewal process for beneficiaries.
3. A majority of states (38, not including Washington, D.C.) have enacted more robust pharmacy controls in order to control Medicaid costs. Cost control initiatives include subjecting more drugs to prior authorization, implementing or expanding preferred drug lists and seeking new or enhanced supplemental rebates.
4. Seventeen states and Washington, D.C., reduced benefits under their respective Medicaid programs. These reductions include restrictions and complete elimination of some benefits.
5. Another notable nationwide trend is the transfer of state Medicaid beneficiaries to managed care plans. Lawmakers have touted the move as an impetus for cost savings and improved care coordination. Louisiana, for instance, is the latest state to receive federal approval to have its Medicaid program run through different managed care plans. Kentucky also enacted similar plans this year.
Similarly, Kansas Gov. Sam Brownback proposed a plan to overhaul the state's Medicaid program, which includes moving Medicaid recipients into managed care plans operated by private companies.
6. States' spending for Medicaid is projected to increase 28.7 percent in fiscal year 2012 to make up for the loss of federal shares of Medicaid spending under the American Recovery and Reinvestment Act. That stimulus money expired in June. Even with these and other cost-cutting measures, Medicaid officials in more than half the states estimate at least a 50 percent chance that they will see a budget shortfall this fiscal year as enrollment continues to grow.
7. By the end of fiscal year 2012, 14 states increased copayment amounts or imposed new copayments, compared to only one in fiscal year 2010. Most copayment changes were for pharmacy and emergency room visits.
1. One of the most notable trends related to Medicaid cost containment looks to be changes to provider payments under state Medicaid programs. By the end of fiscal year 2012, 45 states and Washington, D.C., will have restricted provider payments. The five states that have not include Wisconsin, West Virginia, North Dakota, Iowa and Alaska.
2. Three states — Hawaii, Connecticut and Arizona — enacted cuts to eligibility for Medicaid by fiscal year 2012. This may involve changes to eligibility standards, application and renewal process or premiums. Other actions restricting eligibility include freezing enrollment. Illinois was the only state so far to have made changes to the application and renewal process for beneficiaries.
3. A majority of states (38, not including Washington, D.C.) have enacted more robust pharmacy controls in order to control Medicaid costs. Cost control initiatives include subjecting more drugs to prior authorization, implementing or expanding preferred drug lists and seeking new or enhanced supplemental rebates.
4. Seventeen states and Washington, D.C., reduced benefits under their respective Medicaid programs. These reductions include restrictions and complete elimination of some benefits.
5. Another notable nationwide trend is the transfer of state Medicaid beneficiaries to managed care plans. Lawmakers have touted the move as an impetus for cost savings and improved care coordination. Louisiana, for instance, is the latest state to receive federal approval to have its Medicaid program run through different managed care plans. Kentucky also enacted similar plans this year.
Similarly, Kansas Gov. Sam Brownback proposed a plan to overhaul the state's Medicaid program, which includes moving Medicaid recipients into managed care plans operated by private companies.
6. States' spending for Medicaid is projected to increase 28.7 percent in fiscal year 2012 to make up for the loss of federal shares of Medicaid spending under the American Recovery and Reinvestment Act. That stimulus money expired in June. Even with these and other cost-cutting measures, Medicaid officials in more than half the states estimate at least a 50 percent chance that they will see a budget shortfall this fiscal year as enrollment continues to grow.
7. By the end of fiscal year 2012, 14 states increased copayment amounts or imposed new copayments, compared to only one in fiscal year 2010. Most copayment changes were for pharmacy and emergency room visits.
Related Articles on Medicaid:
CMS Approves Louisiana's Medicaid Overhaul
Arkansas Names New Medicaid Director to Oversee Program Overhaul
GAO Report Presents Adjustment to Medicaid Federal Assistance Formula