ABSTRACT
The respective roles of states and the federal government in health reform is a defining feature of any proposal. Heterogeneity among states implies the need for different approaches in different places, but a possible consequence is variation in results and outcomes around the nation.
Subject(s)
Health Care Reform/organization & administration , Health Policy , State Health Plans/organization & administration , Eligibility Determination , Federal Government , Health Care Reform/economics , Health Care Reform/standards , Humans , Politics , State Health Plans/economics , State Health Plans/standards , United StatesABSTRACT
This roundtable examines the role of health services research from the perspective of the state legislature. Four research and policy experts-each of whom is a current or former legislator-explore how research can be translated effectively into state health policy, and how researchers and legislators can communicate clearly with one another and engage in productive collaborations.
Subject(s)
Health Policy/legislation & jurisprudence , Health Services Research , Policy Making , State Health Plans/legislation & jurisprudence , Cooperative Behavior , Decision Making, Organizational , Diffusion of Innovation , Humans , Interinstitutional Relations , Politics , State Government , United StatesABSTRACT
Medicaid is a cornerstone of this country's health care system, covering over 50 million people and supplying one in five health care dollars in the United States. Medicaid is again a contested issue in state capitols, where states facing sluggish revenues target Medicaid since it is the second largest and fastest growing component of state spending. Managed care was the policy tool many states embraced in order to slow Medicaid spending, and while managed care has had some successes in improving Medicaid services, it has not met states' expectations for cost savings. This analysis explores several reasons why these savings have not been realized, and proposes policy reforms for state Medicaid programs that would make Medicaid coverage more stable, thereby increasing the ability of managed care plans and network providers to work with Medicaid beneficiaries to change patterns of care and realize real savings.
Subject(s)
Managed Care Programs/organization & administration , Medicaid/organization & administration , Policy Making , State Health Plans/organization & administration , Cost Savings , Delivery of Health Care , Health Expenditures , United StatesABSTRACT
Drawing on a decade of analysis and examination of the Medicaid program, this paper assesses what we have learned about Medicaid--its role, its successes, and its setbacks. In the absence of universal coverage for health and long-term care, Medicaid is a critical component of our social safety net, taking on the highest-risk, sickest, and often most expensive populations from private insurance and Medicare. Yet the substantial costs to federal and state governments incurred in filling this role, especially in lean economic times, remain its greatest challenge.
