Medicaid: Spending Pressures Spur States Toward Program Restructuring

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Report Type	Reports and Testimonies
Report Date	Jan. 18, 1996
Report No.	T-HEHS-96-75
Subject	Disadvantaged persons Eligibility criteria Health care planning Health insurance cost control Health maintenance organizations Managed health care Medicaid Medical information systems Quality assurance State-administered programs Waivers Supplemental security income AFDC Aid to Families with Dependent Children Program Arizona Medicaid Managed Care Program Oregon TennCare

Summary:

Several factors, including federal mandates that expand eligibility, medical price inflation, and creative financing schemes, have boosted Medicaid costs. To contain these expenses, 22 states have recently sought waivers from federal regulations that limit their ability to run extensive managed care programs. Some of these states have required the enrollment of their acute care patients--primarily low-income women and children--into managed care programs and have expanded coverage to previously ineligible persons. Arizona, which runs a Medicaid managed care program under a federal waiver obtained more than 10 years ago, has lowered Medicaid spending by millions of dollars. It also leads the states in its development of information systems for collecting medical encounter data essential for assessing quality of care.

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Medicaid: Spending Pressures Spur States Toward Program Restructuring