Tuesday, August 02, 2005
S. Carolina Medicaid reform moving forward
[Howard Gleckman, "Radical Surgery For Medicaid?", Business Week, 8 August 2005.]
Mike Bond - who addressed legislators here in Kansas on Medicaid reform last year - is finding a more receptive audience elsewhere. The good news is there is still plenty of opportunity for Kansas policymakers to take a leadership role:
The 40th anniversary of Medicaid is on July 30, but few will celebrate. The state and federal program that provides essential health benefits for the poor is in big trouble across the country -- under fire for providing often substandard care even as it breaks the budgets of many states. Now, in what could be the first step toward a fundamental remaking of the huge public program, South Carolina's Republican governor, Mark Sanford, has quietly asked the federal government for permission to redesign Medicaid for the 800,000 low-income residents of his poor, largely rural state.
Under Sanford's proposal, Medicaid would be dramatically transformed. It would no longer provide unlimited care, instead offering beneficiaries -- mostly mothers with children -- a fixed amount of money each year to buy insurance and pay out-of-pocket costs. If they run through their accounts, they would have to pay for additional care on their own. But if they hold spending down, they could bank the leftover money to pay future medical costs -- or even use it to buy private insurance if they leave the program. "This is the biggest change ever for Medicaid," says Cleveland State University finance professor Michael Bond, who helped design the plan.
The Centers for Medicare & Medicaid Services, which oversees Medicaid, already backs the concept. "These kinds of approaches can lead to lower costs and more effective treatment," says CMS director Mark B. McClellan. "You can't treat chronic illness without active patient involvement. And you can't get that through some government pricing program."
The jury is still out on whether health accounts -- which are increasingly common in the employer setting -- can save money or improve care. But with Medicaid costs threatening to overwhelm his budget, Sanford is willing to roll the dice on private accounts. And if, as anticipated, the feds give him the O.K., expect other governors to follow suit.
[Michael Bond and Matthew Hisrich, "Medicaid Lessons from Former Communists," WIBA Newsletter, February 2005.]
[Howard Gleckman, "Radical Surgery For Medicaid?", Business Week, 8 August 2005.]
Mike Bond - who addressed legislators here in Kansas on Medicaid reform last year - is finding a more receptive audience elsewhere. The good news is there is still plenty of opportunity for Kansas policymakers to take a leadership role:
The 40th anniversary of Medicaid is on July 30, but few will celebrate. The state and federal program that provides essential health benefits for the poor is in big trouble across the country -- under fire for providing often substandard care even as it breaks the budgets of many states. Now, in what could be the first step toward a fundamental remaking of the huge public program, South Carolina's Republican governor, Mark Sanford, has quietly asked the federal government for permission to redesign Medicaid for the 800,000 low-income residents of his poor, largely rural state.
Under Sanford's proposal, Medicaid would be dramatically transformed. It would no longer provide unlimited care, instead offering beneficiaries -- mostly mothers with children -- a fixed amount of money each year to buy insurance and pay out-of-pocket costs. If they run through their accounts, they would have to pay for additional care on their own. But if they hold spending down, they could bank the leftover money to pay future medical costs -- or even use it to buy private insurance if they leave the program. "This is the biggest change ever for Medicaid," says Cleveland State University finance professor Michael Bond, who helped design the plan.
The Centers for Medicare & Medicaid Services, which oversees Medicaid, already backs the concept. "These kinds of approaches can lead to lower costs and more effective treatment," says CMS director Mark B. McClellan. "You can't treat chronic illness without active patient involvement. And you can't get that through some government pricing program."
The jury is still out on whether health accounts -- which are increasingly common in the employer setting -- can save money or improve care. But with Medicaid costs threatening to overwhelm his budget, Sanford is willing to roll the dice on private accounts. And if, as anticipated, the feds give him the O.K., expect other governors to follow suit.
[Michael Bond and Matthew Hisrich, "Medicaid Lessons from Former Communists," WIBA Newsletter, February 2005.]
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