Report: Record Medicaid Growth, Reforms

CAL/AAEM News Service calaaem.news.service1 at gmail.com
Tue Oct 20 11:49:05 PDT 2015


       

 

October 16, 2015

 

Report: Record Medicaid Growth, Reforms

 

 

 
<http://www.californiahealthline.org/capitol-desk/2015/10/report-record-medi
caid-expansion-reforms> California Healthline

 

 

By Rebecca Vesely

 

Medicaid expansion under the Affordable Care Act in 29 states, including
California, has driven record enrollment and spending for the program in
fiscal year 2015, according to a report by the Kaiser Family Foundation.

 

In California, about 12 million people are enrolled in the Medicaid program,
called Medi-Cal.

 

In states that expanded Medicaid, enrollment and spending grew nearly three
times that of non-expansion states. Medicaid spending rose 17.7% in
expansion states, compared to 6.1% in non-expansion states. Enrollment rose
by 18% overall in expansion states, compared to 5.1% in non-expansion
states, according to the report that surveyed Medicaid directors in 50
states.

 

Because the federal government has picked up all costs of covering newly
eligible enrollees, states that expanded Medicaid saw more modest spending
growth (3.4%) compared to non-expansion states (6.9%), the report authors
found.

 

"States that opted to expand Medicaid saw significant gains in coverage,
reductions in the uninsured, and access to additional federal funds," said
Diane Rowland, executive vice president of the Kaiser Family Foundation.
"But many other changes are underway in Medicaid programs across the country
as states engage in an array of delivery system reforms to help coordinate
care and control costs."

 

Managed care is now the predominant delivery system for Medicaid in most
states including California. A total of 39 states, including California,
have managed care contracts, and California is one of 19 states with Primary
Care Case Management (PCCM), a fee-for-service system where beneficiaries
get primary care along with case management from providers for a small fee,
according to the report.

 

In California, 77% of Medi-Cal beneficiaries are in managed care plans,
according to the report.

 

California is one of seven states with a hospital Delivery System Reform
Incentive Payment (DSRIP) program, in which safety-net hospitals receive
payment incentives in exchange of achieving pre-set quality, care
coordination and access milestones. New Hampshire and Washington states are
seeking approval to launch similar programs, according to the report.

 

Ten states have all-payer claims databases, which can be a valuable tool to
identify areas for reform. California and Washington state plan to launch
all-payer claims databases in fiscal year 2016, according to the report.

 

 

 

Jeff Wells
Deputy Editor, CAL/AAEM News Service

 

Brian Potts MD, MBA
Managing Editor, CAL/AAEM News Service

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