Noteworthy News

States Experimenting With Medicaid

Many states are responding to continuing budget pressures and the anticipated 2014 Affordable Care Act expansion of Medicaid eligibility by attempting to develop new ways to serve their Medicaid population.

The primary vehicle for such experimentation is the section 1115 Medicaid waiver, which gives states limited authority to operate outside established federal Medicaid guidelines.

States are using this flexibility to test new approaches to serving their Medicaid population:  new enrollment procedures, new eligibility criteria, new cost-sharing requirements, new uses of managed care, and new models for service delivery and payment.

Many urban safety-net hospitals may find themselves operating under such waivers.  Others may be located in states where officials will be watching these experiments closely in search of ideas that they themselves may seek to implement.

The Kaiser Commission on Medicaid and the Uninsured takes an in-depth look at states’ use of the section 1115 waiver to test these new approaches in a report titled “An Overview of Recent Section 1115 Medicaid Demonstration Waiver Activity.”  You can find that report hereiStock_000015640638XSmall.

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