By Martha Heberlein
This edition of the report has 4 chapters (not to mention the always appreciated MACStats!).
The first chapter focuses on the more than 9 million individuals under age 65 who qualify for Medicaid on the basis of having a disability. Medicaid plays a vital role for people with disabilities a role that has only expanded in recent years – as the report points out, between 1975 and 2008, enrollees with disabilities were the fastest growing eligibility group in Medicaid and accounted for half of program spending growth. This chapter includes eligibility and population characteristics, services and spending, as well as highlighting opportunities for improving quality.
The second chapter examines access to care for the more than 40 million children enrolled in Medicaid and CHIP compared to similarly situated uninsured children and those with ESI. Similar to other analyses, they find that children enrolled in Medicaid/CHIP are more likely to have a usual source of care, have had a well-child or specialist visit in the past year, and are less likely to have delayed medical care when compared to uninsured children. In comparison to kids with ESI, the picture is a bit more complex, but overall, their access and use of care is similar. We’ll get more into this in a future blog.
Chapter 3 reviews how states finance Medicaid and takes a closer look at health care related taxes and supplemental payments to providers. This chapter also provides an update on federal CHIP financing, including a brief discussion of how allotments are calculated and how the contingency fund operates. Spoiler alert – the FY 2012 CHIP allotments are in the MACStats chapter on page 139!
The final chapter looks at program integrity in Medicaid, describing state and federal initiatives to safeguard against fraud and abuse. It points out that the potential for duplication of efforts exists because of the number of statutory provisions, administration initiatives, and agencies (both state and federal) focused on program integrity and makes some recommendations on how to get the most out of such efforts.
Enjoy your weekend reading – I will.