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Monday, October 24, 2005

Published in The Wichita Eagle on September 20, 2005

STATE SEEKS TO SLOW MEDICAID GROWTH

By STEVE PAINTER, Eagle Topeka bureau

TOPEKA - A legislative panel began looking Monday for ways to rein in the rapidly rising cost of Medicaid, which covers health care expenses for the poor, the elderly and the disabled.

The state's cost jumped more than 25 percent in the budget year that ended June 30 and has risen 142 percent over the past decade, despite eligibility requirements that are among the tightest in the nation.

The factor driving those costs is familiar to non-Medicaid patients as well: the rising cost of health care services of all kinds. The state's cost per recipient accounts for 59 percent of the increase in recent years, with new enrollment accounting for the balance.

"This is an enormous topic," said Sen. Derek Schmidt, R-Independence, who leads the Special Committee on Medicaid Reform.

The best the committee can hope for, he said, is to control the growth.

Senate and House members of the panel will meet five more times before the 2006! Legislature convenes in January.

Across the nation, states are exploring ways to slow the growth. This year, $2.2 billion will be spent on Kansas Medicaid recipients, nearly 10 percent of the population.

The state's share of that cost is about $880 million, with the federal government covering the rest.

Elsewhere, Missouri is implementing cuts that will end services to about 100,000 people over two years, and Tennessee has ended services to about 190,000, according to the Kansas Health Institute, a Topeka-based research group that studies health care issues.

Although Kansas' eligibility requirements are tighter, the committee likely will revisit rules that shelter some assets, such as income-producing property and personal property such as jewelry and antiques.

Rules could be changed to require Medicaid recipients to sell those assets to help pay for their health care.

The panel also will review past audits that have raised questions abo! ut transportation costs billed to Medicaid and the share of money that goes to independent agencies that handle the paperwork for billing Medicaid.

"I would be aggressive like a dog," advised Barb Hinton, head of the Legislature's auditing division.

Although children in poverty account for the biggest enrollment increases in recent years, they also are the cheapest, at an average cost of $2,460 a year.

Elderly Kansans, some in nursing homes and some receiving home and communit y-based services, cost $7,310 a year. Disabled clients cost $11,460 a year.

About two-thirds of Kansans are covered by insurance through an employer, according to the Health Institute. The other third are almost equally divided, having Medicaid, private insurance or no insurance.

Andy Allison, director of health care finance and organization for the institute, cautioned lawmakers that they face "tough choices with real consequences for people's lives."

In addition to reviewing assets, transportation costs and billing agents, Schmidt said he hopes to look at incentives for people to buy long-term care insurance to keep them out of the system.

But in the bigger cost picture, he said, "these are going to be small steps."

The committee meets again Sept 26.

Neufeld addresses issues with long- term health care

By RACHEL DAVIS
rdavis@gctelegram.com
Posted in The Garden City Telegram on Wednesday, September 28, 2005 3:05:49 PM

The possibility of a Medicaid system collapse is looming closer, said Melvin Neufeld, chairman of the state House Appropriations Committee.

Neufeld, R-Ingalls, addressed an audience of about 30 Tuesday at Fiesta Courtyard during a Kansas Health Care Association meeting.

Neufeld said the current system will not be able to provide for the baby boomers when it comes time for them to retire unless the system is reformed.

"In 2030, most retirees will not have enough income or assets to cover basic expenses of nursing home assistance," he said. "In 2044, the growth of the population 85 years and older is expected to triple."

Neufeld said Medicaid is not just a statewide issue but has been affecting people nationwide. He said Medicaid covers only a small amount of the cost of long-term services, which puts many people in debt.

For example, a nursing home room may cost $3,000 a month, and Medicaid may cover only $750 a month, which leaves residents and family members scrambling to cover the cost.

One solution to the Medicaid system is home equity, said Steve Moses, president of the Center for Long-term Care Reform Inc.

Moses said people can take out a reverse mortgage on their home that would allow them to pay the bank in small amounts while still using the equity as income to pay for long-term care services. Moses said weeding out the myths and misconceptions of Medicaid, which tell people if they don't take care of their future then they can become a burden of the state and taxpayers, and allowing people to plan for their retirement would save taxpayers millions of dollars.

"We have been sending a message to the public for the last 40 years that if you get sick, someone else will pay for it," he said.

Moses said people can avoid the Medicaid trap by taking out insurance on their estate, using the worth of their house or by transferring from non-exempt assets to exempt assets.

"Don't get me wrong, there is no reason why a person should have to give up the family farm to provide long-term care for loved ones," he said. "We are trying to find ways to balance the system out."

Gil Cruz, co-owner of Homestead Assisted Living, said he has had to use last year's rates to take on clients so they could afford the care.

"It is a struggle because I have an obligation to this community to provide affordable care," Cruz said. "It's hard to find a balance between the obligation and running a business."

He said he worries about the future of long-term care patients and workers.

"I don't know what is going to happen if the residential population keeps rising and the work force population keeps declining," Cruz said.

Nancy Benney, Kansas Health Care Association chairwoman, said she is worried about the quality of long-term assistance, especially with a decrease in nurse training.

"It has become even more of a challenge to take care of residents who are sicker now than they were 10 years ago," she said.


Tuesday, October 11, 2005


Health Savings Accounts Available to Kansas Government Employees


Health Savings Accounts are now available to Kansas state employees as part
of Governor Kathleen Sebelius' 2006 health plan, according to a
press release
posted on the Governor's Web site.


HSAs provide employees direct control over the quality of their health care
coverage and save employees money in the form of lower annual medical expenses.
Additionally, HSAs encourage pre-tax savings for future health related costs.


The Flint Hills Center for Public Policy identified expected benefits HSAs would offer to employers, employees, the economy, the state budget and the health care industry in policy papers, editorials and Health Savings Account Workshops.Dr. Devon Herrick details how and why HSAs make sense for both public and private employees in, "HSAs for State and Local Employees," an opinion piece published this past May.


Additional Flint Hills Center resources on HSAs include:

Health Savings Accounts: The Future Of Health Care For Kansans

All About HSAs

First Things First: Kansas Medicaid Program Must Get Its House In Order Before Expanding Home-Based Care

Hsas Treat Ills Of Health Care Payment System

Choice Is Revolutionizing Health Care


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