On June 28, 2005, Chuck Milligan, executive director of the Center for Health Program Development and Management, testified to the Senate Finance Committee at the invitation of Senator Charles Grassley, committee chairman. Mr. Milligan discussed state Medicaid financing arrangements, such as intergovernmental transfer (IGT) and upper payment limit (UPL) arrangements that involve public hospitals and nursing facilities, as well as Medicaid school-based reimbursement. Click here for Mr. Milligan’s written testimony and here for his oral testimony.
Home- and community-based services waiver programs enable many individuals dually eligible for Medicare and Medicaid to avoid nursing homes. But access to prescription drugs may be impeded when drug coverage is transferred from Medicaid to Medicare in January 2006, threatening the ability of dual eligibles to remain in the community. The Center examined the likely impact of the new Medicare drug benefit in Maryland and recommends federal policy remedies.
In a Medicaid study required by Michigan’s legislature, the Center evaluated whether capitated managed care involving multiple managed care organizations (MCO) is cost effective, when compared to three alternative delivery systems: fee-for-service, primary care case management, and a capitated managed care program involving a single statewide MCO. The Center’s analysis concluded that the state of Michigan would save between $28 million and $129 million in state funds in FY 2006 when the current capitated program involving multiple MCOs is compared to all of the alternative delivery systems. The exact amount of savings that Michigan will achieve depends on the size of the managed care rate increase in FY 2006, and on which alternative delivery system is under consideration.
The Center is pleased to announce a new partnership with the New Mexico Human Services Department and New Mexico State University. The Center will assist New Mexico in developing and evaluating new Medicaid policies and programs. Initial work will focus on consumer-directed services and managed long-term care.
As Medicaid managed care programs mature, states are looking to refine their methods for measuring and improving the performance of participating health plans. This report serves as a guide for Medicaid agencies who want to develop a performance measurement program using administrative data to evaluate the care provided to enrollees with chronic diseases. The report identifies potential performance indicators that are associated with improved medical outcomes and demonstrates the application of diagnosis-based risk adjustment to performance measurement by profiling six health plans.