States are Using Flexibility with Medicaid
In June 2016, the Center on Budget and Policy Priorities (CBPP) reported that “States Are Using Flexibility to Create Successful, Innovative Medicaid Programs.”
“State Medicaid programs across the country are tailoring services and models of care to local needs in ways that streamline health care delivery and improve health. These innovative models demonstrate that current Medicaid rules allow states significant flexibility, and disprove claims by proponents of block-granting Medicaid or imposing a per capita cap, as the House Republican budget plan would do, that current Medicaid rules inhibit state reforms.”
One excellent example of a state using flexibility under Medicaid is Missouri. In Missouri, “health homes” coordinate the care of individuals with chronic physical health conditions or a serious mental illness. In collecting data early on, the state has seen savings in hospital emergency room and has prevented hospitalizations.
Money Follows the Person is another great program that 44 states, including NJ, currently participate in. Through Money Follows the Person,Medicaid recipients are moving from nursing homes into either their own homes or a community based facility. States like Tennessee see large savings when individuals who can live in less restrictive and expensive settings, are moved out of nursing homes.
“Yet the large and growing cuts that would result from converting Medicaid into a block grant or establishing a per capita cap would force states either to provide considerably more state funding for Medicaid, or, as is more likely, to institute substantial cuts to eligibility, benefits, and/or provider payments. Moreover, the resulting financial squeeze could also halt or reverse progress toward further integrating care and strengthening the health care delivery system for Medicaid beneficiaries by changing Medicaid agencies’ focus to making cuts rather than investing in efforts aimed at improving the delivery of care.”
States are showing that Medicaid can be used to connect systems that traditionally function in silos and that serve the same individuals. “In sum, Medicaid gives states financial support and considerable flexibility to respond to crises and develop innovative new models of care.”