Monday, April 25, 2005
Mike Bond on Medicaid
[Michael Bond, "Improve Medicaid quality with market reforms," The Tallahassee Democrat, 23 April 2005.]
Michael Bond, who spoke on Medicaid reform for Flint Hills in Kansas last year, is urging systematic overhaul of the program in states around the country. Here is a recent commentary from a paper in Florida:
Virtually every state - including Florida - is looking for ways to put its Medicaid plan on a sustainable fiscal basis.
Equally important, though, is the critical problem of addressing the quality of care provided to Medicaid participants. Any reform that deals with solely the program's costs ignores the important issue of quality.
The source of these problems is twofold. First, Medicaid reimbursements to providers are not determined in a private market but instead are "administered" prices that are determined by government edict.
The second symptom of stingy Medicaid payments is low-quality care. Because it is extremely difficult to control utilization in fee-for-service plans, some Medicaid providers respond by providing low-quality care. They cram their schedules with more (and shorter) office visits, order unnecessary tests, lengthen hospital stays and engage in outright billing fraud.
[T]urning the delivery of Medicaid services into a competitive marketplace will dramatically reduce these quality problems. First, it will ultimately replace all fee-for-service and cost-based reimbursement schemes with prepaid managed-care plans. Second, by providing beneficiaries with funding and the right to choose the medical services they need from competing providers, the marketplace will innovate to deliver higher-quality care while simultaneously innovating to control costs.
[Michael Bond and Matthew Hisrich, "Medicaid Lessons From Former Communists," Wichita Independent Business Association Newsletter, February 2005.]
[Michael Bond, "Improve Medicaid quality with market reforms," The Tallahassee Democrat, 23 April 2005.]
Michael Bond, who spoke on Medicaid reform for Flint Hills in Kansas last year, is urging systematic overhaul of the program in states around the country. Here is a recent commentary from a paper in Florida:
Virtually every state - including Florida - is looking for ways to put its Medicaid plan on a sustainable fiscal basis.
Equally important, though, is the critical problem of addressing the quality of care provided to Medicaid participants. Any reform that deals with solely the program's costs ignores the important issue of quality.
The source of these problems is twofold. First, Medicaid reimbursements to providers are not determined in a private market but instead are "administered" prices that are determined by government edict.
The second symptom of stingy Medicaid payments is low-quality care. Because it is extremely difficult to control utilization in fee-for-service plans, some Medicaid providers respond by providing low-quality care. They cram their schedules with more (and shorter) office visits, order unnecessary tests, lengthen hospital stays and engage in outright billing fraud.
[T]urning the delivery of Medicaid services into a competitive marketplace will dramatically reduce these quality problems. First, it will ultimately replace all fee-for-service and cost-based reimbursement schemes with prepaid managed-care plans. Second, by providing beneficiaries with funding and the right to choose the medical services they need from competing providers, the marketplace will innovate to deliver higher-quality care while simultaneously innovating to control costs.
[Michael Bond and Matthew Hisrich, "Medicaid Lessons From Former Communists," Wichita Independent Business Association Newsletter, February 2005.]
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