CSG Midwest
Minnesota was an early adopter of the use of health care homes, and a five-year study of their impact shows promising results for any state looking to reduce health costs and improve patient outcomes.
“Given how much is spent for Medicaid, Medicare and dually eligible enrollees, you can create large savings and bend the cost curve,” says Douglas Wholey, a professor of health policy at the University of Minnesota and the study’s lead evaluator.

Gov. Matt Bevin, elected in November 2015 and who had pledged during his campaign to eliminate Medicaid expansion which brought health coverage to 400,000 previously uninsured individuals, announced yesterday his plan to transform Kentucky’s Medicaid system through an 1115 waiver. The new waiver will cover almost all the Medicaid enrollees eligible under the pre-expansion rules as well as all the newly eligible under the expansion rules.

Bevin said his plan is an opportunity “to come up with what is going to be truly a transformative and sustainable and fantastic program,” according The Courier-Journal coverage of the press conference. He pledged to both save money—$2.2 billion in combined state and federal funding over the next five years—and reduce the number of Medicaid enrollees—86,000 people by 2021 by moving them to private insurance.  

According to two recent studies, states that chose to expand Medicaid coverage under the Affordable Care Act have experienced budget savings, revenue gains, and stronger hospitals as a result.

An informational bulletin was released June 1, 2016,  by federal Medicaid officials to inform states how to use Medicaid funds to help states and territorities to prevent, detect and respond to the Zika virus.

For instance, states could choose to cover the costs of over-the-counter insect repellants if prescribed by a health care professional. Additional family planning counseling can be a tool to prevent the spread of the Zika virus and...

CSG Midwest

Under managed care, states do not pay health care providers on a fee-for-service basis. Instead, MCOs are paid an agreed-upon amount for each member’s health care expenses. Adjustments can be made to the per-member fee based on the health status of the member. Savings are shared between the states and the MCO, the latter of which assumes the risk of cost overruns.

Iowa began its journey to managed care by issuing a request for proposals early last...

Despite pushing the federal government to provide 100 percent of the cost for health care for American Indians, what South Dakota Gov. Daugaard has characterized as a longstanding treaty obligation, on Feb. 29 Daugaard ruled out Medicaid expansion during this legislative session.

Last week, two states rejected Medicaid expansion, another is continuing negotiations with Washington and one is studying whether and how to continue expansion already in place and reduce the numbers of people eligible. Currently 31 states and the District of Columbia have expanded income eligibility for Medicaid as provided for by the Affordable Care Act. Sixteen states remain firmly in the non-expansion column.

On Tuesday, Jan. 12, John Bel Edwards signed his first executive order as Louisiana’s new governor to expand Medicaid eligibility to an estimated 300,000 individuals. The expansion is to be effective no later than July 1, 2016 according to the order.

Louisiana becomes the 31st state (plus DC) to expand Medicaid income eligibility as permitted by the Affordable Care Act.

South Dakota Gov. Dennis Daugaard may find that the third time is the charm as he negotiates with the federal government to live up to its treaty obligations to provide health services to the state’s Native Americans. Twice before in recent state history, governors have tried and failed to solve the longstanding problem, which results in a massive cost shift to state revenues to pay for health care for many Native Americans. In his Dec. 8, 2015, budget address in Pierre, S.D., Daugaard proposed that should the federal government fulfill its obligation to provide health services to Native Americans, the state would use the projected $67 million annual savings to the state to finance the cost of Medicaid expansion.

CSG Director of Health Policy Debra Miller outlines the top five issues in health policy for 2016, including Medicaid expansion, substance abuse and drug overdoses, cost containment, the graying of America, and population health. 

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