New analysis out yesterday looks at Utah’s Medicaid costs and offers ways to become more efficient. Here is the Salt Lake Tribune’s coverage of the analysis:
Utah’s Medicaid program isn’t providing enough oversight of its managed care plans, a problem that is costing the state as much as $19 million, according to a Legislative audit released Tuesday. Milliman Incorporated, a consulting firm hired to help with the audit, found $6 million to $12 million that could be saved if two providers — Molina Healthcare Utah and Select Access — matched the rates of the lowest-cost provider, Healthy U. The audit also found the jointly-run state and federal program overpaid for emergency room care in fiscal year 2009 by $7 million. And it suggests possible routes to more savings, such as reducing ER visits….
The audit recommends Medicaid return to the flat fees, which give plans an incentive to control costs. Medicaid switched to that payment model for Molina in September.”We do not think the cost-plus contracts have been optimal,” state Medicaid director Michael Hales told the Legislative Audit Subcommittee Tuesday. “We do, however, think they are better than the alternative fee-for-service (model).”
John Hammarlund, Regional Administrator for the Centers for Medicare & Medicaid Services, addresses this question at Healthcare Town Hall.
Transcript:
Barry: John Hammarlund, Medicaid & Medicare are kind of at Ground Zero of this demographic time bomb of potentially skyrocketing healthcare costs for the country going forward over the next 20 or 30 years. I’m wondering about your perspective on the potential for healthcare informatics and electronic health records to help us muffle that bomb.
John Hammarlund: Well, actually, I want to thank Ron for bringing up the case of his mother, because actually that’s a perfect argument for why Medicare aspires to have electronic health records for every one of our millions and millions of beneficiaries. It’s not just that it makes good clinical sense, which of course, it does.
One of the Town Hall panelists, Will Fox (FSA, MAAA), testified before Congress on September 19. He spoke about how low Medicare rates (and lower Medicaid rates) are increasing the cost of commercial insurance.
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