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Medicaid Works: Evolving to Improve Health, Lower Costs

This is the next in our “Medicaid Works” blog series, which aims to inform the debate over Medicaid’s future by providing the latest facts and figures on this essential and popular part of the nation’s health care system.

As our paper on state Medicaid innovations details, a number of states are using their flexibility under Medicaid to adopt positive changes rather than punitive, ineffective ones like co-payments, premiums, and work requirements.  And the examples continue to grow.

States are implementing initiatives that coordinate care for Medicaid beneficiaries with chronic health conditions, reduce unnecessary emergency room use, and help people transition from nursing facilities into their communities.  Our paper and this post give some examples, such as:

  • Tennessee is one of 44 states participating in the Money Follows the Person program, which helps Medicaid beneficiaries transition from nursing facilities to their own homes, the home of a caregiver, or a community-based residential facility. Tennessee’s program has produced significant state savings by reducing unnecessary nursing facility stays. 
  • A Wisconsin hospital is testing a new way to integrate health services for children with complex medical needs, a rapidly growing group with high health care costs.  Participants are significantly more likely to report that their health needs are being met.

More changes are on the horizon.  New regulations from the Centers for Medicare and Medicaid Services will modernize Medicaid managed care plans and provide opportunities for states to develop innovative models of care.  Requirements that insurers participating in Medicaid cover mental health and substance use disorder treatment to the same extent as physical health services will give millions of beneficiaries new access to behavioral health care.  And guidance released last year explained how Medicaid can help people with disabilities, older adults needing long-term services and supports, and chronically homeless people stay out of institutions by finding and keeping housing in the community. 

These new opportunities for states are supporting exciting new changes in the way Medicaid beneficiaries obtain care. 

Learn more about how Medicaid works for children, families, and seniors across the country: