March | April 2017


Technology Offers Savings, Fair and Timely Justice

By National Association of Medicaid Directors Executive Director Matt Salo
The question of how to produce savings in Medicaid is almost as old as the program itself. While Medicaid traditionally has sought cost savings via cutting eligibility, benefits or reimbursement rates, state Medicaid directors are recognizing that we cannot continue to cut our way out of this problem. In fact, there is growing awareness that the solutions lie along a different path, that of a broader delivery system and payment reforms.
In this context, Medicaid agencies across the country are examining all their possible levers to affect change, including collaborative efforts with other stakeholders. And other stakeholders in reform likewise must look to Medicaid. Medicaid has become—in many states—an important player and powerful tool in multipayer initiatives that bear the promise of improving not just Medicaid, but also the entirety of the U.S. health care market.
While these changes will take on different aspects depending on the state, the core themes stress moving away from traditional uncoordinated fee-for-service, both as a delivery model and as a payment incentive. The acute, behavioral, pharmaceutical and long-term care needs of the Medicaid population are not, and cannot, be met in the current siloed system where no individual provider or entity is responsible for holistically treating the patient. This is especially true for the seniors and individuals with disabilities that comprise the bulk of the program’s spending. Better integrating or coordinating the care for these populations—hand-in-hand with changes in how we pay for their care—is clearly a huge part of the solution and has the potential to reduce costs, as well as dramatically improve the health care outcomes of our most vulnerable citizens.
The National Association of Medicaid Directors works with states to share best practices and lessons learned in these areas. Here are some examples of these types of efforts.