What’s New with Medicaid Expansion?

With so many changes and updates in healthcare, we’re sure your email box is overflowing like ours. There are Home Health and OASIS-C1 changes coming, as well as Hospice changes. It still is important to keep tabs on the changing insurance marketplace related to the Affordable Care Act, too.Medicaid Expansion by State_map

Each state is making the decision to expand Medicaid services. Click here for a link to the Commonwealth Fund’s map to show the current status of every state as of July 2013 (data courtesy of the Kaiser Family Foundation).

The Kaiser Family Foundation also published an infographic titled “Medicaid Expansion Under the Affordable Care Act” to provide a visual for current data in The Journal of the American Medical Association (JAMA. 2013; 309(12):1219. doi:10.1001/jama.2013.2481).

Additional information and resources related to the dually eligible can DualEligiblebe found in the Underserved Population Best Practice Intervention Package on pages 14-21.

Here are a few key statistics about the dually eligible from the BPIP:

  • Dual-eligible patients account for almost 40 percent of Medicare and Medicaid costs, and impact growth in entitlement spending (Feder, Clemans-Cope, Coughlin, Holahan, and Waidmann, 2011)
  • Nine million people are classified as dual-eligible and their cost of care is 1.8 times higher than for people only on Medicare (Feder, Clemans-Cope, Coughlin, Holahan, and Waidmann, 2011)
  • Unfortunately, high costs and high service utilization does not always lead to good outcomes for persons who are dual-eligible.  Medicare and Medicaid have been tasked to reduce costs while improving outcomes for this population.  Dual-eligible patients have a high utilization of emergent care and hospitalizations, which are typically covered by Medicare.  The Affordable Care Act (ACA) mandates that Medicare improve coordination for its beneficiaries related to reducing hospitalizations.

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