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.
Medicaid and Complex Care
State governments around the nation have a long history of acting as health care innovators and pioneers. With the population aging and more Americans becoming eligible for Medicaid, states are ...
Ms. Vikki Wachino Director, Center for Medicaid and CHIP Services Centers for Medicare and Medicaid Services Department of Health and Human Services 200 Independence Avenue, SW Washington, DC 20201 Re: ...
Alabama Gov. Robert Bentley has announced the Alabama Medicaid Agency’s regional care organization plan, which provides medical care to most Alabamians on Medicaid, has been approved by the Centers for Medicare ...
In the February 2016 issue of Capitol Ideas, NGA Executive Director and CEO Scott Pattison outlines financial challenges states face in 2016. Some highlights from the article: Though states have experienced ...
States face the ongoing challenge of managing the costs of their Medicaid programs while ensuring beneficiaries have access to quality health care. A more rigorous purchasing approach can help states ...
The Honorable Orrin Hatch Chairman Committee on Finance United States Senate 219 Dirksen Senate Office Building Washington, D.C. 20510 The Honorable Ron Wyden Ranking Member Committee on Finance United States ...
WASHINGTON—National Governors Association (NGA) Chair Utah Gov. Gary Herbert and Vice Chair Virginia Gov. Terry McAuliffe today delivered the fourth annual State of the States address at the National Press Club. “It’s the states ...
Mr. Andy Slavitt Acting Administrator Centers for Medicare & Medicaid Services U.S. Department of Health and Human Services Hubert Humphrey Building, Room 445-G 200 Independence Avenue, SW Washington, DC 20201 ...
The Honorable John Boehner Speaker U.S. House of Representatives Washington, D.C. 20515 The Honorable Nancy Pelosi Democratic Leader U.S. House of Representatives Washington, D.C. 20515 The Honorable Mitch McConnell Majority ...
Across the country, health care systems continue to grapple with how best to serve patients with the greatest needs. These complex care patients, sometimes referred to as super-utilizers, have comorbid ...
