HHS aims to lower Medicaid costs, add flexibility

The U.S. Department of Health and Human Services (HHS) has introduced four initiatives designed to offer states more flexibility to coordinate care for for Medicaid and Medicare recipients while helping to reduce costs.

Some of the initiatives, announced April 14, help implement provisions of the Patient Protection & Affordable Care Act (PPACA). According to the HHS:

  • 15 states will receive federal funding to develop better ways to coordinate care for people with Medicare and Medicaid coverage, also known as dual-eligibles, who often have complex and costly healthcare needs.
  • All states will gain increased flexibility to provide home and community-based services for more people living with disabilities.
  • All states are eligible to receive more money to develop simpler, more efficient Medicaid enrollment systems.
  • A proposal by the state of New Jersey for flexibility to expand health coverage for nearly 70,000 low-income residents has been approved.

Under an initiative funded by the PPACA, 15 states will receive up to $1 million each to develop new ways to meet the medical needs of those who are eligible for both the Medicare and Medicaid programs. The goal is to eliminate duplication of services for these patients and expand access to needed care. CMS’ new Federal Coordinated Health Care Office will work with the states to implement strategies to coordinate primary, acute, behavioral and long-term supports and services for dual-eligibles.

The 15 states that will receive these funds are California, Colorado, Connecticut, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oklahoma, Oregon, South Carolina, Tennessee, Vermont, Washington and Wisconsin.

The second proposal would give states flexibility for their programs to help people with disabilities choose to live in their communities rather than in institutions. The proposed rules reduce administrative barriers for states seeking to help multiple populations such as seniors and/or people with different types of disabilities.

Another set of rules issued will provide 90 percent of the cost for states to develop and upgrade their IT systems to help people enroll in Medicaid or the Children’s Health Insurance Program (CHIP), and cover 75 percent of ongoing operational costs. The previous federal matching rate was 50 percent. The rules establish performance standards for the improved eligibility systems to promote greater efficiency and a more consumer-friendly enrollment process, according to HHS.

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