Guest Blog: Medicaid's Morphing - Are You?
The following is a guest blog from Anthony Cirillo, FACHE, ABC:
The numbers don't add up. States are in a budget crisis facing shortfalls. So what are states trying to do? Get creative of course. And that can only mean bad news for providers. Let's look at some of the things swirling around.
Block Grants
A block grant is a large sum of money granted by the national government to a regional government with only general provisions as to the way it is to be spent. They allow regional governments to experiment with different ways of spending money. My guess is that because block grants only have general provisions attached to how they are spent, it gives states great latitude to "put the screws" to healthcare organizations and use the funding for other purposes. OK, so that is my crude interpretation. Maybe some of the policy wonks can expand on this by commenting.
You're Fat, So Pay Up
Arizona Gov. Jan Brewer (R) has proposed enacting an annual $50 surcharge for obese Medicaid enrollees, a move she says would help Arizona's financially troubled Medicaid program. If approved, the fee would be the first time a state or federally funded healthcare program for the poor fined individuals for unhealthy habits or behaviors, The Wall Street Journal reported. The plan would mean childless obese adults who receive Medicaid would be required to follow a doctor's weight loss plan or be charged an additional $50 a year for coverage. Smokers would be subject to the same requirement.
You're Misusing Health Services, So Pay Up
Florida is proposing a $100 fee for people who use the emergency department as their primary care office. And they want to collect a $10 premium from every Medicaid recipient save nursing home residents. According to Kaiser, the new premium could violate the 2010 health care law, which bars states from making it more difficult for people to enroll in Medicaid. The ED co-pay is estimated to generate about $9 million a year. And if 2 million of Florida's 3 million Medicaid recipients paid the $10 fee, it would bring in $240 million annually.
So what is going on in your state? States are starting to take the airline approach to creative revenue streams and they are cash-strapped. If nothing else get involved in your association's advocacy agenda. Things are changing too fast not to be up to speed.
Anthony Cirillo is the about.com expert in assisted living. A speaker, health care consultant, senior advocate and blogger, he consults with long-term care facilities and is available for management retreats and association keynotes. He is the author of "Who Moved My Dentures?" His company, Fast Forward Consulting empowers organizations to change the healthcare experience and leverage it in their marketing. For more information go to More at www.4wardfast.com and www.anthonycirillo.com.