Reforming Medicaid

Reforming Medicaid

Sept. 5, 2017

JAMA article link

Hello readers! For those of you who don't know me yet, I am Alexis Mack. I'm currently a senior biochemistry student at the University of New Hampshire with a minor in health management. With biochemistry consisting of very little business education, I thought it'd be a good idea to take up a minor in how to "effectively" run a health care facility, as I hope to become a physician in the future. Currently, there is a lot of talk about health care reform in regards to President Trump and the rest of congress, but most comes from biased news sources. My goal through this blog is to try to keep up with these reforms, based on articles and talks from congressmen, administrators, and other government officials.

A hot topic currently is the removal of the Affordable Care Act, ACA, and the implementation of a new program, or Trump-care. A recent post in the Journal of the American Medical Association came from Andy Slavitt, head of the Centers for Medicaid and Medicare Services, CMS, under President Obama, as well as Gail Wilensky, who was the head of a department similar to CMS under President Bush, have written an article about what reforms should take place in terms of Medicaid.

Interestingly, this article comes from that of a democrat and republican together, which is far from the ordinary with the current state of the government. They discuss bipartisan changes that will, hopefully, gain full government support. They feel that rather than removing the entire Medicaid system, that the government should work on building up the pieces that currently work well, and improve any issues that do not work at all. Removing an entire system and implementing a new one would cost the government more than it would save them to get rid of the current system. A general consensus of the two parties is that there is change that needs to be done in healthcare.

Some of the issues they addressed is how the federal government reimburses states, physicians, and hospitals who see Medicaid beneficiaries. Currently, most of the reimbursement comes from supplemental pools, but this pays way over the base payment that is due to cover the cost of the patient's service. This is a large expensive that shows the government not allocating it's resources correctly, as well as not maintaining a strong watch over the Medicaid system.

https://kaiserfamilyfoundation.files.wordpress.com/2016/06/8884-figure-1.png

This figure shows the excess in spending due to supplemental pools. Another reform they believe should be implemented is creating a universal database that can regular the Medicaid system. This would be available to all states, and it could keep track of all the Medicaid data to ensure the best allocation of financial resources and reimbursements.

For me, this article was an interesting way to see our two parties come together and figure out reform protocols that could be implemented to allow full support from both parties. It is impressive to see these two leaders, who have different overall views on how the government should be run, coming together to fight for what needs to be done. Our health care system is at the brink of massive change, and I feel that an incorrect reform could push our system over the edge. Hopefully, the two party system can come together just as these administrators to figure out the best way to handle one of our nation's most pressing issues currently.