The Center for Health Care Strategies, Inc. released a brief examining sustainability issues created by expanding Medicaid, as the national health care reform law does.  The author posits that without reforming the way states deliver and fund care, the expansion is unsustainable.  The brief outlines opportunities available to states to redesign Medicaid payment policies to ensure beneficiaries receive high-quality, cost-effective care.

From the report: Health care reform holds the promise of near universal coverage and Medicaid is the foundation for it, eventually covering more than 75 million Americans. This brief’s goal is to promote Medicaid’s ability to buy value — cost-effective, quality care — in both the acute and long-term care sectors. Specifically, it addresses four issues: (1) the importance of payment reform in Medicaid; (2) the challenges Medicaid faces in implementing payment reforms; (3) payment reform opportunities in Medicaid; and (4) how federal and state roles might shift to create a more dynamic and effective partnership for tackling complicated and politically charged payment issues. By raising questions about Medicaid’s rate-setting policies and their relationship to access, quality, and cost containment, we hope to inform and advance discussions on reforming Medicaid’s payment systems.

Full report: Payment Reform: Creating a Sustainable Future for Medicaid (PDF | 191.9 KB)

Center for Health Care Strategies, Inc.  (2010).  Payment reform: creating a sustainable future for Medicaid.  Bachrach, D.