State Medicaid Program Management: Update and Considerations
New Issue Brief examines challenges to improve care quality, reduce costs
States are at a critical juncture in managing their Medicaid programs. Challenged with continued slow economic recovery, constrained budgets, diminishing revenues, and looming Affordable Care Act (ACA)-driven enrollment increases, states have to look for creative and innovative ways of controlling medical and administrative program costs while improving quality and outcomes.
Effective management of state Medicaid programs is a hot-button issue. Total Medicaid spending accounts for 2.7 percent of the U.S. Gross Domestic Product (GDP) and in many states, Medicaid is the single largest health care insurer and the largest budget item, second to education.
State Medicaid Program Management: Update and Considerations, an Issue Brief from the Deloitte Center for Health Solutions, provides an update on state Medicaid programs and considerations for stakeholders as states identify ways to improve care management and reduce costs. This Issue Brief:
- Summarizes states’ responsibilities in Medicaid administration and financing, and program and benefit design.
- Examines three drivers impacting Medicaid spending and costs – enrollment, medical inflation, and medical utilization.
- Reviews select ACA provisions – in particular, Medicaid coverage expansion (Section 2001) – and how they are expected to impact states as they play a major role in the Act’s implementation.
- Provides snapshots of innovative Medicaid management strategies under way in dozens of states.
- Identifies key stakeholder considerations for improving Medicaid management.
Local and regional factors, along with unique patient profiles, make a one-size-fits-all approach to controlling Medicaid costs and improving quality unlikely to succeed. Rather, individual states are anticipated to initiate, design, and develop solutions to improve their Medicaid management programs.
To read the full Issue Brief, please download the attachment.