Webinar: Talking Medicaid
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Listen to a recording of Talking Medicaid, the May 4 webinar sponsored by the Alliance. The slide presentation is also available for downloading.
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Webinar: Talking Medicaid
- 1. Talking Medicaid: First Steps in Building Effective Homelessness-Health Care Partnerships May 4, 2011
- 7. Medicaid Populations MACPAC. “Report to the Congress on Medicaid and CHIP.” March 2011. http://www.macpac.gov/reports For more information about Chronic Homelessness policy solutions, find our policy brief at http://www.endhomelessness.org/content/general/detail/2685
- 18. Bonus Points – Medicaid & Budgets Kaiser Family Foundation – Commission on Medicaid and the Uninsured. “Top 5 Things To Know About Medicaid.” February 25, 2011. http://www.kff.org/medicaid/8162.cfm
Notas del editor
- [Rachel’s turn] Thank you, Lisa. So currently, there are about 62 million individuals enrolled in Medicaid. About 50% are children and 25% are elderly and disabled individuals. In 2009, the federal and state government spent around $338 billion on Medicaid and $17 billion alone on hospitals that serve the uninsured. By numbers alone, we see that Medicaid provides a fairly sizable budget for health care services for low-income individuals. In fact, as a comparison, the budgets for the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration combined is around $11 billion. Those are the agencies that administer programs targeted for chronically homeless people, as well as funding for mainstream safety net programs. This underlines how large Medicaid is and its overall scale in the parts of the health care system that are most relevant to us.
- Rachel: Although Medicaid services can be reimbursed from the state directly to health care providers, many states have contracts with managed care plans to provide services in full or in part. 70% of Medicaid enrollees nationally are in managed care. In 2010, about a quarter of Medicaid spending on benefits went to managed care plans. Some states, like South Carolina and Tennessee, enroll all Medicaid participants in managed care while other states like Alaska and Wyoming, do not have Medicaid managed care at all. Under Medicaid managed care, instead of the state agency paying every provider separately for patient encounters, the state pays private plans a negotiated amount for each member-enrollee. The plans work with providers to assure access and coordinate care. Lisa: Managed care in Medicaid can be controversial. Managed care can result in better care coordination; or it can lead to “cherry picking” – which is what we call “creaming” – plans marketing themselves to the healthiest consumers so they have to spend less on care and can gain more in profit. Or, if they cannot avoid enrolling higher-cost members, plans might find ways to skimp on care, and save money for themselves that way. Some think that managed care systems can do a good job serving people with co-occurring conditions , using subcontracts with behavioral health providers. Researchers and policy analysts have a lot of questions about how Medicaid managed care works best in supportive housing. Mainstream health care advocates are generally not convinced that Medicaid managed care is good for people in Medicaid. … I’ll leave it at that for now.