Friday, August 19, 2005
Colorado empowers Medicaid recipients
[John Andrews, "Rocky Mountain Medicaid," The Wall Street Journal, 18 August 2005.]
Policymakers that are willing to allow Medicaid beneficiaries more control over their care are increasingly finding that satisfaction increases and costs decline. Considering that cost and quality of care are the two perennial problems with Medicaid, this is a huge development:
CDAS, our state's experiment with Consumer-Directed Attendant Support for the severely disabled, got started in 2002. The wheelchair-bound Linda Storey was one of its first four clients. The program now has 146 participants, each newly empowered to hire and fire their own caregivers. Quality of care and patient satisfaction are up, costs are down, and legislators approved offering the option for 33,000 Medicaid recipients statewide in 2006.
"It gives you your life back," [Linda] Storey told me. "I'm in control of my health now." Under a federal waiver obtained by Colorado officials, she selects the health aides who come to her house, bypassing the provider agencies otherwise required under Medicaid rules for home- and community-based services.
Jessica, a 21-year-old anthropology student, now gets to be one of those paid caregivers. Nowadays, the entire team of aides is reliable and well qualified, she told me -- in contrast to the ill-trained and even scary individuals sent in by agencies over the years. Several even robbed the family, Jessica recalled.
"Since I have been on CDAS . . . I have more freedom to live my life as every American should -- and I'm saving the government money," [says Storey.]
With Medicaid expenses surging faster than almost every other budget line in almost every state, such savings are welcome news to policy makers. Taxpayers in Colorado have seen their share of Medicaid -- matched dollar for dollar with federal funds -- increase almost 33% since 2001. Another 22% jump is predicted by 2010.
The first two years of Colorado's CDAS pilot program, by contrast, showed average monthly spending at 21% under budget ($3,925 per client allocated, $3,131 expended). While the sample is tiny, the vector is positive for once.
The goal is clear, according to Matt Dunn, a young dentist named by Gov. Owens to the Medicaid oversight board. First give patients freedom to choose. Then align incentives so the choices go less and less toward a demeaning, inefficient government delivery model. "Socialized medicine benefits no one," Mr. Dunn insists with Colorado candor. To which Linda Storey would say alleluia, amen.
[Devon M. Herrick, "Give Medicaid recipients more control," The Wichita Eagle, 3 March 2005.]
[John Andrews, "Rocky Mountain Medicaid," The Wall Street Journal, 18 August 2005.]
Policymakers that are willing to allow Medicaid beneficiaries more control over their care are increasingly finding that satisfaction increases and costs decline. Considering that cost and quality of care are the two perennial problems with Medicaid, this is a huge development:
CDAS, our state's experiment with Consumer-Directed Attendant Support for the severely disabled, got started in 2002. The wheelchair-bound Linda Storey was one of its first four clients. The program now has 146 participants, each newly empowered to hire and fire their own caregivers. Quality of care and patient satisfaction are up, costs are down, and legislators approved offering the option for 33,000 Medicaid recipients statewide in 2006.
"It gives you your life back," [Linda] Storey told me. "I'm in control of my health now." Under a federal waiver obtained by Colorado officials, she selects the health aides who come to her house, bypassing the provider agencies otherwise required under Medicaid rules for home- and community-based services.
Jessica, a 21-year-old anthropology student, now gets to be one of those paid caregivers. Nowadays, the entire team of aides is reliable and well qualified, she told me -- in contrast to the ill-trained and even scary individuals sent in by agencies over the years. Several even robbed the family, Jessica recalled.
"Since I have been on CDAS . . . I have more freedom to live my life as every American should -- and I'm saving the government money," [says Storey.]
With Medicaid expenses surging faster than almost every other budget line in almost every state, such savings are welcome news to policy makers. Taxpayers in Colorado have seen their share of Medicaid -- matched dollar for dollar with federal funds -- increase almost 33% since 2001. Another 22% jump is predicted by 2010.
The first two years of Colorado's CDAS pilot program, by contrast, showed average monthly spending at 21% under budget ($3,925 per client allocated, $3,131 expended). While the sample is tiny, the vector is positive for once.
The goal is clear, according to Matt Dunn, a young dentist named by Gov. Owens to the Medicaid oversight board. First give patients freedom to choose. Then align incentives so the choices go less and less toward a demeaning, inefficient government delivery model. "Socialized medicine benefits no one," Mr. Dunn insists with Colorado candor. To which Linda Storey would say alleluia, amen.
[Devon M. Herrick, "Give Medicaid recipients more control," The Wichita Eagle, 3 March 2005.]
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