Cost and Financing

As states expand access to health insurance coverage under federal health reform, big questions remain about how to simultaneously improve the quality of health care and slow the growth in health costs. This session will focus on how some states have implemented innovative comprehensive programs to address these elusive policy goals.  Presenters will also provide program examples in the areas of administrative efficiencies, prevention and wellness, patient centered health homes, and payment reforms that have proven successful and are ready for replication by other states.

As states expand access to health insurance coverage under federal health reform, big questions remain about how to simultaneously improve the quality of health care and slow the growth in health costs. This session will focus on how some states have implemented innovative comprehensive programs to address these elusive policy goals.  Presenters will also provide program examples in the areas of administrative efficiencies, prevention and wellness, patient centered health homes, and payment reforms that have proven successful and are ready for replication by other states.

As states expand access to health insurance coverage under federal health reform, big questions remain about how to simultaneously improve the quality of health care and slow the growth in health costs. This session will focus on how some states have implemented innovative comprehensive programs to address these elusive policy goals.  Presenters will also provide program examples in the areas of administrative efficiencies, prevention and wellness, patient centered health homes, and payment reforms that have proven successful and are ready for replication by other states.

Senator Richard Moore provides an outline of the parts of Massachusetts health reform that work to contain costs and improve quality, rebutting critics that say the state reform’s primary goal was to expand coverage. In the last slides, he highlights the tobacco cessation program began by Massachusetts Medicaid in 2005. Among Medicaid enrollees, smoking rates decreased by 26 percent.

This presentation explores why it is imperative to slow the growth in spending of Medicaid and other state health programs and why it is so hard to do so. Examples of approaches states have tried and which are the most promising are provided.

Wisconsin, like almost every state, faced a large Medicaid deficit in 2008. This presentation is about the new approach the state adopted to change the nature of the dialogue between the state administration and key stakeholders to find savings and meaningful reforms. Now in its third year, Wisconsin’s ForwardHealth Rate Reform Initiative seeks continuous program improvement.

As states expand access to health insurance coverage under federal health reform, big questions remain about how to simultaneously improve health care quality and slow the growth in health costs. Some states have implemented innovative comprehensive programs to address these elusive policy goals. Presenters discussed successful examples in the areas of administrative efficiencies, prevention and wellness, patient-centered health homes and payment reforms that can easily be replicated in your state.

In 2006, Wisconsin Gov. Jim Doyle announced his “Affordability Agenda.” It included a goal of expanding health care coverage to 98 percent of all the state’s residents. An ambitious plan in any economy, it was even more of a challenge with what was to come just a year later—The Great Recession. Regardless of the economy, Wisconsin pushed ahead with BadgerCare Plus, one of eight national winners of CSG Innovations Awards.

Due in part to higher-than-expected growth in Medicaid expenditures in fiscal year 2010, states have taken a number of actions to control program spending during the current fiscal year and beyond.

Quitting tobacco use improves individuals’ health, but state governments also benefit. State Medicaid programs pay an average $607 million per year in tobacco-related health care costs, and employees who quit using tobacco take fewer sick days and have lower health care costs. For every dollar states spend on smoking cessation, returns to the state average $1.26 in avoided productivity losses, direct medical expenditures and premature deaths. The American Lung Association and the Partnership for Prevention analysis of insurance coverage for smoking cessation treatment is summarized, including state by state listing of coverage in state Medicaid and state employee plans for smoking cessation, as well as statewide workplace smoking bans.

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