Toward real medicaid reform

Health Affairs

Volumn 26, Issue 2, 2007, Pages

  Holahan, John ^a   Weil, Alan ^b,c  

^a URBAN INSTITUTE   (United States)

^b National Academy for State Health Policy   (United States)

^c National Academy for State Health Policy   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; COST BENEFIT ANALYSIS; COST CONTROL; HEALTH CARE PLANNING; HEALTH CARE POLICY; HUMAN; MANAGEMENT; MEDICAID; NEEDS ASSESSMENT; ORGANIZATION AND MANAGEMENT; REIMBURSEMENT; UNITED STATES;

COST CONTROL; COST-BENEFIT ANALYSIS; HEALTH CARE REFORM; HUMANS; MEDICAID; NEEDS ASSESSMENT; POLICY MAKING; REIMBURSEMENT, DISPROPORTIONATE SHARE; STATE HEALTH PLANS; UNITED STATES;

EID: 33947321707     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.26.2.w254     Document Type: Article

References (53)

1. Although not specific to Medicaid, the general case for overuse as a concern is set forth in President's Council of Economic Advisors, Economic Report of the President (Washington: U.S. Government Printing Office, February 2006);
2. and M.F. Cannon, "Medicaid's Unseen Costs," Cato Institute Policy Analysis no. 548 (Washington: Cato Institute, 18 August 2005).
3. References by political leaders to Medicaid as a Cadillac program are legion. For example, see radio address by Tennessee Gov. Phil Bredesen, 11 June 2005, http://democraticgovernors.org/news/280 (accessed 9 February 2007).
4. See, for example, the description of the Market-Based Medicaid Reform Act developed by the American Legislative Exchange Council, available at http://alec.org/2/4/talking-points/5.html (accessed 9 February 2007).
5. P. Cunningham and J. May, "Medicaid Patients Increasingly Concentrated among Physicians," Tracking Report no. 16 (Washington: Center for Studying Health System Change, August 2006).
6. T.A. Coughlin, S.K. Long, and Y. Shen, "Assessing Access to Care under Medicaid: Evidence for the Nation and Thirteen States," Health Affairs, 24, no. 4 (2005): 1073-1083;
7. and S. K. Long, T. Coughlin, and J. King, "How Well Does Medicaid Work in Improving Access to Care?" Health Services Research 40, no. 1 (2005): 39-58.
8. Urban Institute tabulations from the Medicaid Statistical Information System, 1 September 2002.
9. L. Ku and V. Wachino, "The Effect of Increased Cost-Sharing in Medicaid: A Summary of Research Findings" (Washington: Center For Budget And Policy Priorities, 7 July 2005);
10. and M. Reed, "An Update on Americans' Access to Prescription Drugs," Issue Brief no. 95 (Washington: HSC, May 2005).
11. J. Holahan and A. Ghosh, "Understanding the Recent Growth in Medicaid Spending, 2000-2003," Health Affairs 24 (2005): w52-w62 (published online 26 January 2005; 10.1377/hlthaff.w5.52);
12. and J. Holahan and M. Cohen, Understanding the Recent Changes in Medicaid Spending and Enrollment Growth between 2000-2004, Pub. no. 7499 (Washington: Kaiser Commission onMedicaid and the Uninsured, May 2006).
13. J. Hadley and J. Holahan, "Is Health Care Spending Higher under Medicaid or Private Insurance?" Inquiry 40, no. 4 (2003): 323-342.
14. J. Holahan, "Variation in Health Insurance Coverage and Medicaid Expenditures: How Much Is Too Much?" in Federalism and Health Policy, ed. J. Holahan, A. Weil, and J.M. Wiener (Washington: Urban Institute, 2003), 111-143;
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27. Authors' calculations from MMIS data.
28. Congressional Budget Office, March 2006 baseline.
29. Ibid.
30. Kaiser Commission on Medicaid and the Uninsured, An Update on the Clawback: Revised Health Spending Data Change State Financial Obligations for the New Medicaid Drug Benefit, Pub. no. 7481 (Washington: Kaiser Commission, March 2006);
31. and A. Schneider, The Clawback: State Financing of Medicare Drug Coverage, Pub. no. 7118 (Washington: Kaiser Commission, June 2004).
32. A. Sommers and M. Cohen, Medicaid's High Cost Enrollees: How Much Do They Drive Program Spending? Pub. no. 7490 (Washington: Kaiser Commission, March 2006).
33. S.M. Lieberman et al., "Reducing the Growth of Medicare Spending: Geographic versus Patient-Based Strategies," Health Affairs 22 (2003): w603-w613 (published online 10 December 2003; 10.1377/hlthaff.w3.603);
34. and K.E. Thorpe and D.H. Howard, "The Rise in Spending among Medicare Beneficiaries: The Role of Chronic Disease Prevalence and Changes in Treatment Intensity," Health Affairs 25 (2006): w378-w388 (published online 22 August 2006; 10.1377/hlthaff.25.w378).
35. G.F. Anderson, "Medicare and Chronic Conditions," New England Journal of Medicine 353, no. 3 (2005): 305-309;
36. R. Berenson and J. Horvath, "Confronting the Barriers to Chronic Care Management in Medicare," Health Affairs 22 (2003): w37-w53 (published online 22 January 2003; 10.1377/hlthaff.w3.37);
37. E. H. Wagner, B.T. Austin, and M. Von Korff, "Organizing Care for Patients with Chronic Illness," Milbank Quarterly 74, no. 4 (1996): 511-544;
38. and Medicare Payment Advisory Commission, Report to the Congress: Increasing the Value of Medicare (Washington: Med PAC, June 2006), chap. 2.
39. J.L. Wolff and C. Boult, "Moving Beyond Round Pegs and Square Holes: Restructuring Medicare to Improve Chronic Care," Annals of Internal Medicine 143, no. 6 (2005): 439-445;
40. and CBO, "An Analysis of the Literature on Disease Management Programs," 13 October 2004, http://www.cbo.gov/ftpdocs/59xx/doc5909/10-13- DiseaseMngmnt.pdf (accessed 18 December 2006).
41. U.S. Government Accountability Office, "Medicaid: States' Efforts to Maximize Federal Reimbursements Highlight Need for Improved Federal Oversight," Statement of Kathryn G. Allen before the Senate Finance Committee, 28 June 2005 (Washington: GAO, 2005);
42. and T.A. Coughlin, B.K. Bruen, and J. King, "States' Use of Medicaid UPL and DSH Financing Mechanisms," Health Affairs 23, no. 2 (2004): 245-257.
43. S. Schwartz et al., "Moving Beyond the Tug of War: Improving Medicaid Fiscal Integrity" (Portland, Maine: National Academy for State Health Policy, August 2006).
44. L. Dubay, J.M. Haley, and G.M. Kenney, Children's Eligibility for Medicaid and SCHIP: A View from 2000, New Federalism: National Survey of America's Families, Pub. no. B-41 (Washington: Urban Institute, March 2002).
45. L. Etheredge and J. Moore, "A New Medicaid Program," Health Affairs 22 (2003): w426-w439 (published online 27 August 2003; 10.1377/hlthaff.w3.426).
46. Authors' calculations of data from the Medical Expenditure Panel Survey, 2001-2003 Merged Files.
47. S.B. Dale and J.M. Verdier, "Elimination of Medicare's Waiting Period for Seriously Disabled Adults: Impact on Coverage and Costs," Issue Brief (New York: Commonwealth Fund, July 2003).
48. S.P. Burke, J. Feder, and P.N. Van de Water, eds., Developing a Better Long Term Care Policy: A Vision and Strategy for America's Future (Washington: National Academy of Social Insurance, 2005).
49. E. O'Brien, Medicaid's Coverage of Nursing Home Costs: Asset Shelter for the Wealthy or Essential Safety Net, Issue Brief (Washington: Georgetown University Long Term Care Project, May 2005).
50. V. Miller and A. Schneider, The Medicaid Matching Formula: Policy Considerations and Options for Modifications, Pub. no. 2004-09 (Washington: AARP Public Policy Institute, September 2004).
51. C.N. Kahn III and R.F. Pollack, "Building a Consensus for Expanding Health Coverage," Health Affairs 20, no. 1 (2001): 40-48;
52. M.V. Pauly, "An Adaptive Credit Plan for Covering the Uninsured," in Covering America: Real Remedies for the Uninsured, ed. J.A Meyer and E. Wicks (Washington: Economic and Social Research Institute, June 2001), 135-152;
53. and J.M. Lambrew, J.D. Podesta, and T.L. Shaw, "Change in Challenging Times: A Plan for Extending and Improving Health Coverage," Health Affairs 24 (2005): w119-w132 (published on-line 23 March 2005; 10.1377/hlthaff.w5.119).