Improving care for Medicaid's sickest 5% could help reduce funding gap

Politico reports that the Obama administration is targeting this very needy population, many of whom are known as dual eligibles, for better care because — although their numbers are actually quite small — the amount of program money they use is quite large.

Politico: Saving By Taking Care Of The Sickest
As governors have been sounding the alarm about a collective $175 billion shortfall in state Medicaid budgets in the coming fiscal year, the Obama administration is looking to reduce the gap by improving the treatment of just 2.9 million of Medicaid's 58 million enrollees. How could the treatment of just 5 percent of beneficiaries make a dent in such a huge funding gap? Because, President Barack Obama told the National Governors Association in February, "we know that over half of all Medicaid costs come from just 5 percent of enrollees." Many of these patients are known as "dual eligibles," poor elderly or disabled individuals who qualify for Medicare as well as Medicaid. They are among the patients with the severest need for care and the fewest resources to get it (Feder, 3/15).

Meanwhile, news outlets also are reporting state-level Medicaid news:

Health News Florida: Medicaid Bill Eyes HMO Profits
As Florida lawmakers get ready to transform Medicaid into a managed-care system, they are split on a complex question: How do you make sure HMOs don't receive a windfall at the expense of patient care? A House health-care committee Monday for the first time took up a bill that calls for the state to take a cut if Medicaid managed-care plans make more than 5 percent profits (Saunders, 3/14).

Minnesota Public Radio: Expanded Medicaid A Lifesaver For Rural Poor In Minn.
For many of those people in Greater Minnesota, the expansion of Medicaid means they'll be able to access health care closer to home. That's good news to Jacque Morrow, 43, a homeless woman who sometimes seeks shelter at the People's Church in Bemidji. ... The Medicaid expansion in Minnesota is part of the federal health care overhaul. Along with 32,000 GAMC clients, the expansion shifts 51,000 low-income adults from the MinnesotaCare program to Medical Assistance. It also will cover an additional 12,000 people who currently have no insurance (Robertson, 3/14).

Kansas Health Institute News: More Than 120 Ideas Submitted For Changing Kansas Medicaid
The ideas were solicited by Lt. Gov. Jeff Colyer, who is leading a [Gov.] Brownback administration team tasked with remaking Kansas Medicaid. ... Colyer's team is looking for between $200 million and $400 million in savings or cuts that it can propose. ... The proposals have been divided by the health policy authority into 14 categories ranging from administrative reorganization to payment reform. ... The greatest number of recommendations, 17, fell under the category of "Benefit Changes," most of which proposed expansions of current benefits (3/14).

California Healthline: Mental Health Comes Up $1.4 Billion Short
According to a study just released by National Alliance on Mental Illness, California spent $587 million fewer dollars on mental health services than it did two years ago. Add in the $861 million in redirection of Prop. 63 funds in the proposed new budget, and you're looking at a total loss of roughly $1.4 billion in mental health funding. ... The state's proposed realignment shifts more responsibility for mental health services to the counties, and provides the cash to make that work. ... [And] the 10 percent reduction in Medi-Cal reimbursement will likely cause some providers to stop taking Medi-Cal patients, including some with mental health issues (Gorn, 3/14).