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In an effort to inform state-level discussion of healthcare savings opportunities, Missouri Foundation for Health funded a report that estimates the impact of six scenarios that could help contain escalating costs in Missouri while improving quality. The scenarios include: implementing mandatory managed care for dual eligibles; adopting bundled payment methods; enabling a robust insurance exchange; promoting shared decision making and palliative care; care coordination and disease management; and broadening the scope of practice of primary care practitioners.
The state’s Medicaid Redesign Team announced $14 million was saved in the 2011-12 fiscal year. The savings came without reducing benefits, while implementing a global spending cap and expanding coverage to include 140,000 additional low-income people.
According to a report by the New Hampshire Insurance Department, hospital charges include relatively large markups. Uncovered costs and emergency services are major cost pressures for hospitals. Twenty percent of costs, or $900 million, were uncovered in 2010 alone. According to the report, in order to decrease the cost of non-emergency services, payers must be willing to increase reimbursement of emergency services.
NC Health News reports Community Care of North Carolina, the state Medicaid program that assigns patients to a “medical home,” has saved the state close to a billion dollars over a four year period, according to analysts who examined four years of state Medicaid cost data. The study found the use of medical homes not only reduced cost but also increased healthcare quality, especially among the high cost and high need patients.
In the Healthy Indiana Plan Demonstration Section 1115 Annual Report, an evaluation of the predecessor program found that the program attracted many consumers with chronic disease as they had no other insurance option. While many were able to make their contributions to the POWER accounts, 14 percent of former HIP members reported that cost-sharing was their reason for leaving the program.
The state’s Medicaid Redesign Team completed a Multi -Year Action Plan with several recommendations to improve health outcomes and curb the cost trend that include expanding access to supportive housing, expanding provider scope of practice, targeting trouble areas, such as Brooklyn, and implementing a system of performance measurement.
Alaska’s reimbursement rates exceed that in comparison states for physician services, according to a report by Milliman. Alaska’s relative reimbursement is 160 percent of that of Washington, Oregon, Idaho, Wyoming and North Dakota, across all payers and all specialties analyzed.
Cost shifting between commercial and public payers, high operational costs for healthcare providers and high physician reimbursement rates all drive healthcare spending in Alaska, according to a report by Milliman. Two previous commissioned reports identified that Alaska’s reimbursement exceeds that in the comparison states for both physician and hospital services likely due, at least in part, to the large negotiating leverage providers have in the small market of Alaska. Hospitals criticized the report for a variety of reasons, including the comparison between tax paying for-profit hospitals in Alaska to nonprofit hospitals in the comparison states.
Alaska’s commercial payment levels are approximately 213 percent of Medicare payment levels, on par with Washington, Oregon, Idaho, Wyoming and North Dakota, according to a report by Milliman. This is the first of three reports commissioned by the state in an attempt to understand where opportunities exist to quell the unsustainable cost of care.
Healthcare spending has increased 40 percent between 2005 and 2010 and anticipated to reach more than $14 billion by 2020, according to the University of Alaska Anchorage. This comprehensive review describes how spending is divided among payers, healthcare costs, age of recipients and service.