Posted on 01/08/2019 2:54:31 PM PST by spintreebob
Medicaid health plans are starting to pay for non-traditional services such as meals, transportation, housing and other forms of assistance to improve members’ health and reduce medical costs.
That change follows efforts by state Medicaid programs to give health plans financial incentives to control spending, said Jill Rosenthal, senior program director for the National Academy for State Health Policy.
Rather than continue to pay a set fee each month to cover members’ health costs, many states are implementing policies that let health plans share in any savings they can demonstrate. That provides motivation for insurers to address factors such as literacy and poor housing, which can drive up health costs.
“Health plans now have incentives for them to find the root causes of problems that will reduce costs that will benefit the plan, its beneficiaries and the states,” Rosenthal said.
(Excerpt) Read more at khn.org ...
We have an existing status quo. What minor tweaks should happen? What major changes should happen?
We libertarians would like to eliminate it completely. That is not going to happen. Can we have creeping libertarianism? or Creeping self-responsibility?
How do we get from here to there?
Medicaid is paying for my assisted living housing. Makes life a lot easier for me with my health condition and disability.
More choices for us seniors.
Sounds like Medicare Advantage plans.
Most people don’t have to go to a nursing home which is the most expensive arrangement.
They just need help with medication, meals and trips to doctors appointments.
That’s where assisted living places come in.
Medicaid is comprehensive. With Medicare, you need gap insurance. It doesn’t cover everything.
Most seniors have both.
Or in-home care...which is what my mom has ATM.
Medicaid waiver plans will also pay for in-home care.
Well, sure, but Medicare Advantage plans sometimes offer extras not covered by either regular Medicare or the standard supplemental plans. Worth checking out.
Combine this with social security and then wonder why no one needs or wants children who can care for them in their old age. Now, we need to expand this to all illegal aliens and everyone in the world because the U.S.A. has become wealthy pillaging and plundering the rest of the world. And the New World Order will be named: The United Nations of Venezuela!
GED = health care???
The article looked like it said that because they are saving money, they can do more for prevention. Are they claiming education level is such a big risk they will pay for it? I suppose they’ll pay for college next, because college grads are healthier...
“Creeping self-responsibility?”
Co-pay payment for one visit gets coverage for next visit.
Co-pay payment for one ambulance ride gets coverage for next ambulance ride.
Co-pay payment for one hospitalization gets coverage for next hospitalization.
Medicine is very complex and tough to regulate. One good key is if the patient is willing to pay, then it probably is needed. The rule isn’t always right, but it generally works well.
I have a friend who is blind and a senior. She gets help with housing as well as other services. She has a good support system.
Medicaid’s scope creep in this regard becomes a de facto welfare program.
“College graduates have better life outcomes - here’s your scholarship.”
“You need to eat healthier. Here’s a $500 Subway gift card for the month.”
Transportation to and from medical appointments is a legitimate service but ripe for fraud.
Is Medicare now Medicare. I mean GED? What’s next, Medicare provided Ferraris?
“I could not believe this was something a health insurance company would do,” said Ford, 25. “I thought health insurers only paid for medical costs.”
Not anymore.
Medicaid health plans are starting to pay for non-traditional services such as meals, transportation, housing and other forms of assistance to improve members’ health and reduce medical costs.
That change follows efforts by state Medicaid programs to give health plans financial incentives to control spending, said Jill Rosenthal, senior program director for the National Academy for State Health Policy.
Rather than continue to pay a set fee each month to cover members’ health costs, many states are implementing policies that let health plans share in any savings they can demonstrate. That provides motivation for insurers to address factors such as literacy and poor housing, which can drive up health costs.
“Health plans now have incentives for them to find the root causes of problems that will reduce costs that will benefit the plan, its beneficiaries and the states,” Rosenthal said.
AmeriHealth Caritas CEO Paul Tufano said studies show people with lower educational levels tend to be in poorer health. “Helping members attain their GED can be incredibly consequential for them to live the kind of life they want to live,” he said.
But Tufano acknowledged that only a small fraction of people who need the assistance reach out for it. About 1,000 members have started GED training through the insurer in Pennsylvania, Louisiana, South Carolina and Delaware.
“Many of our members are just surviving to keep their heads over water, holding on to jobs and dealing with issues like safe housing, access to food and transportation to get to work or doctor,” he said.
AmeriHealth Caritas is one of just a handful of Medicaid health plans that offer a GED benefit.
WellCare, which covers 2.2 million Medicaid recipients in Missouri, Nebraska, Georgia, Kentucky, Hawaii and Illinois, had 226 members sit for their GED exams since the plan began paying for it in 2012, said spokeswoman Alissa Lawver. The Tampa-based plan does not know how many passed.
A Wellcare survey of its Medicaid adult members in Georgia in 2012 found that about 20 percent did not have a high school diploma or a GED.
“There is a significant relationship between education and health,” Wendy Morriarty, president of WellCare’s ‘Ohana Health Plan in Hawaii, said when launching the benefit in 2016. “A GED is a tool that can lead to increased opportunities for our members to attend college, seek higher-paying jobs and find stable housing. This benefit has the ability to improve the health and well-being of local families and communities.”
Advocates for Medicaid praise the health plans’ efforts.
“I think this sets the standard for the unique role of Medicaid managed care in bridging health care and social services,” said Sara Rosenbaum, health law and policy professor at George Washington University.
Ford said having a coach at AmeriHealth walk her through the sign-up process for GED classes, help her register for tests and call her twice a week to keep her motivated was vital to her success. The program also offered child care and transportation to the prep classes and exam sites. She started in May 2017, taking two classes a week, and passed her exams last summer.
When she finished, AmeriHealth hired Ford as an intern in its member services department. In December 2017, the insurer hired Ford to a full-time position — with health benefits — to work as a GED coach for other Medicaid members.
The job meant Ford became the first of nine siblings to get off Medicaid and find employer-based coverage.
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