Lec15_medicaid_handout

Lec15_medicaid_handout - Medicaid Medicaid Professor Vivian...

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Medicaid Medicaid Professor Vivian Ho Health Economics Fall 2009
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Topics Topics Coverage and Financing Current Challenges Restraining costs Improving health
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Medicaid Trends Medicaid Trends 1972 17,606 1975 22,007 1985 21,814 1988 22,907 1989 23,511 1990 25,255 1995 36,282 1998 40,096 2001 45,766 2005 57,300 $ 6,300 12,242 37,508 48,710 54,500 64,859 120,141 142,318 186,905 298,200 Year # of Recipients (m) Total Cost ($m)
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Medicaid Recipients, 2005 Medicaid Recipients, 2005 http://www.cms.hhs.gov/MedicareMedicaidStatSupp/ (2008 Edition) % of recipients % of payments Average payment Kids(<21) 47.2% 17.1% $1,729 Adults 21.7% 11.8% $2,585 Age 65+ 7.6% 23.0% $14,402 Perm Disability 14.2% 43.4% $14,536
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Medicaid Financing Medicaid Financing Joint financing by federal and state governments States w/ lowest per capita income receive larger federal subsidies CA, NY receive about 50% federal funding MS, WV receive 76% and 72.99% federal funding respectively
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Minimum requirements for federal matching funds: Must cover Temporary Assistance for Needy Families (TANF) and Supplemental Security Income (SSI) beneficiaries Must provide inpatient and outpatient hospital services, and physician services
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States have wide latitude in setting eligibility and medical benefits Access and costs vary by state Mean Medicaid fee for an office visit, new patient, 30 minutes in 2003: $54.87 (Zuckerman et al 2004) $31.46 for established patient, 15 minutes But wide variation across states (see Exhibit 2) Fees well below Medicare fees in many states State Variations State Variations
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Do differences in the Medicaid program across states make a difference? See Zuckerman et al, Table 4 State Variations State Variations
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SCHIP State Children’s Health Insurance Program Part of 1997 BBA Gave federal funding to states to reduce # of uninsured children States have considerable latitude in programs Expand Medicaid Develop separate children’s health insurance program Both SCHIP enrollment >7m in 2007. Income eligibility levels vary from 300% of federal
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Lec15_medicaid_handout - Medicaid Medicaid Professor Vivian...

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