The Department of Health and Human Services and Florida officials negotiate changes to the state's Medicaid plan. In the meantime, Arkansas doctors offer a cautious endorsement as the state tries "episodic" payments for some common conditions.
The Associated Press: Fla. Medicaid Program In Limbo
Millions of uninsured Florida families and health care providers are in a purgatory of sorts. Gov. Rick Scott and the Republican-led Legislature want to privatize the state's Medicaid program, but need the Obama administration's permission. The Obama administration wants to make more low-income Floridians eligible for Medicaid, but needs Scott and the Legislature to agree. The sides have been negotiating a package deal for more than a year and won't comment (Kennedy, 10/7).
Medpage Today: Medicaid: Docs Cautious About Arkansas Payment Plan
Doctors in Arkansas who treat Medicaid patients are trying their best to put on a happy face about a program there designed to reward quality and move away from a traditional fee-for-service payment model. The cost-sharing program, which started this week and involves Medicaid and some of the state's largest private insurers, will determine if a provider reaches quality and cost targets based on historical models. The Health Care Payment Improvement Initiative, on which Arkansas Medicaid is partnering with two private insurers -- Arkansas Blue Cross and Blue Shield and Arkansas QualChoice -- rewards doctors who manage care and costs well but also withholds reimbursement for those who exceed historical cost levels (Pittman, 10/5).
Politico Pro: Arkansas Tests New Approach To Payments
With a wary nod from the state's doctors, Arkansas has launched an effort to control its health care costs that officials hope will transform its system within a few years. In the initiative begun this month, Arkansas's Medicaid program and two of the state's largest insurers -- Arkansas Blue Cross Blue Shield and QualChoice -- are partnering to introduce "episodic" payments for common conditions. They include upper respiratory infections, hip and knee replacements, attention deficit/hyperactivity disorder, congestive heart failure and perinatal care (Cheney, 10/8).
And Pennsylvania officials suspend a co-pay plan for autism services in its Medicaid program.
Inquirer: Pa. Suspends Autism Co-Pay Plan
State welfare officials have put on hold a plan to force thousands of parents of children with autism and other disabilities to begin paying part of the cost of services that had been provided via Medicaid. Instead of the planned co-pays, the agency said it would pursue federal approval to charge families a monthly premium on a sliding scale (Worden, 10/6).