Medicaid and Complex Care

States continue to drive toward improving the health of their residents and, because health care costs are a large and growing component of state budgets, governors also are looking for long-term, transformational ways to improve the efficiency of their Medicaid programs. Generally, a small segment of the enrollee population account for large portion of states’ Medicaid expenditures. Those individuals with complex care needs, also known as “super-utilizers,” tend to have a history of chronic illness, multiple comorbidities, special needs and other non-clinical complications that may be related to unstable housing, employment, food and transportation and interaction with the criminal justice system. They often use emergency departments and inpatient services when home and community-based interventions could be employed with good outcomes and at lower costs. By appropriately redirecting state funds to address the comprehensive needs of people with complex care needs, states can rein in escalating costs and improve the quality of care delivered to high-risk and vulnerable Medicaid beneficiaries.

Testimony – Medicaid Reform (Energy and Commerce)

Mr. Chairman and distinguished members of the Energy and Commerce Committee. Thank you for requesting that we testify today on ways to address the significant challenges confronting the Medicaid Program ...

Testimony – Medicaid Reform (Finance)

Mr. Chairman, Senator Baucus and distinguished members of the Finance Committee. Thank you for requesting that we testify today on ways to address the significant challenges confronting the Medicaid Program ...

Testimony – Long Term Care Insurance Partnerships

Mr. Chairman and members of the committee, my name is Ray Scheppach, and I am the Executive Director of the National Governors Association. I appreciate the opportunity to appear before ...

Testimony – Medicaid Intergovernmental Transfers

Introduction The Medicaid program is the largest and most important health care program in the country. It currently provides $300 billion per year in critical health care and long-term care ...