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More choices, care coordination are Reform 2020 goals.
More "choices" = more fraud. The providers already abusing the Medicaid system- PCA, transportation, interpretation, adult daycare, etc- are going to be the first ones setting up agencies to offer these new "services." The Medicad program is needed by many, but taken advantage of far too often in this state.
"The result is a map for the remainder of this decade for making Medicaid dollars stretch farther and serve elderly, needy and disabled people better"
further NOT "farther"?
I have been in the healthcare business for over 30 years. For those that accuse providers of fraudulent billing I have to admit that, yes, it does sometimes happen. However, the instances of abuse by those who are on MA happens much more often than any fraudulent billing does.
@Thumper5316- I don't disagree that MA recipients defraud the system through eligibility fraud, identity theft, doctor shopping for pills, and participating in kickback scams with providers, but I can tell you that the provider "abuse" (fraud) is where the money is. Most providers are ethical and rarely even break even from the rates Medicaid pays- when they actually perform the services. The agencies/providers I'm talking about are set up by people with no intention of ever providing legitimate services to those that need it. And- our Medicaid program should not even cover interpretation services- providers are required to have an interpreter available for patients per the ADA, so why are our taxes even paying for the service? Other states don't cover it. If you want cost savings- go for the low-hanging fruit.
Talk about a crock! The writer has no idea beyond a cursory look just what Medicaid is or what it covers. For instance, the claim that Medicaid doesn't cover bathroom modifications is just plain wrong. The various Medicaid waivers in existence for which the more seriously afflicted members of a disability group (AC, CAC, DD, TBI, CADI) will fund modifications pertinent to the disability group in question. I've authorized bathroom modifications, chair-lift installations, handicapped-van modifications, wheelchair-accessible ramps, etc. etc., far more times than I can count--ALL funded with Medicaid dollars. And that deal about Medicaid being either "on" or "off"? Again, a generalization not based on fact. There is an appeal process for all Medicaid decisions (during which the services being appealed cannot be terminated) which more often than not result in the claimant's case being affirmed by the appeals judge and the services granted. To call this piece sloppy journalism is a masterful understatement. Strib--if you're going to print something, at least do your readers the favor of understanding the issue you're writing about.
Medicaid recipients suffer from the same conditions that the general population does, perhaps not quite in exactly the same proportion. The problem is that a tiny percentage consume an enormous part of the healthcare dollar. It probably tends to be worse in Medicaid recipients because of an overall lack of consistent preventive medical care and good diet, but make no mistake - the most voracious American healthcare consumer is obese, diabetic, and expensive. Savings lie in preventing people from getting that way in the first place. That is why insurance companies push healthy living incentives. Healthcare plans need to switch from pouring money into fixing chronic conditions to preventing them in the first place. And consumers need to get off the couch and eat a vegetable - take some personal responsibility and have a stake in their health. That is what will really cut the costs, but the question is where to start: Education? Early intervention? Preferential pricing for preventive healthcare and less largess for hopeless cases near death? We are lagging far behind other nations in healthcare, spending more and getting less. It is time to look at how others do it and get with the program.
An obvious reform is to block grant Medicaid funds to the states. This would grant them greater flexibility in tailoring Medicaid offerings to their state's specific needs, and would place the onus upon the states to limit spending.
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