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Lecture Health economics - Chapter 15: Medicaid. This chapter presents the following content: Coverage and financing, current challenges, medicaid financing, state variations, medicaid & the nursing home market, was the expansion worth it? | Medicaid Professor Vivian Ho Health Economics Fall 2009 Topics Coverage and Financing Current Challenges Restraining costs Improving health Medicaid Trends 1972 17,606 1975 22,007 1985 21,814 1988 22,907 1989 23,511 1990 25,255 1995 36,282 1998 40,096 2001 45,766 2005 57,300 $ 6,300 12,242 37,508 48,710 54,500 64,859 120,141 142,318 186,905 298,200 Year # of Recipients (m) Total Cost ($m) http://www.cms.hhs.gov/MedicareMedicaidStatSupp/LT/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=ascending&itemID=CMS1213767&intNumPerPage=10 Medicaid Recipients, 2005 http://www.cms.hhs.gov/MedicareMedicaidStatSupp/ (2008 Edition) % of recipients % of payments Average payment Kids( The majority of Other recipients are those with “Permanent and total disability.” http://www.cms.hhs.gov/MedicareMedicaidStatSupp/LT/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=ascending&itemID=CMS1213767&intNumPerPage=10 Medicaid Financing Joint financing by federal and state governments States w/ lowest per capita income receive larger federal subsidies CA, NY receive about 50% federal funding MS, WV receive 76% and 72.99% federal funding respectively http://www.cms.hhs.gov/MedicaidDataSourcesGenInfo/downloads/maag2005.pdf 2006 FMAP Minimum requirements for federal matching funds: Must cover Temporary Assistance for Needy Families (TANF) and Supplemental Security Income (SSI) beneficiaries Must provide inpatient and outpatient hospital services, and physician services States have wide latitude in setting eligibility and medical benefits Access and costs vary by state Mean Medicaid fee for an office visit, new patient, 30 minutes in 2003: $54.87 (Zuckerman et al 2004) $31.46 for established patient, 15 minutes But wide variation across states (see Exhibit 2) Fees well below Medicare fees in many states State Variations . | Medicaid Professor Vivian Ho Health Economics Fall 2009 Topics Coverage and Financing Current Challenges Restraining costs Improving health Medicaid Trends 1972 17,606 1975 22,007 1985 21,814 1988 22,907 1989 23,511 1990 25,255 1995 36,282 1998 40,096 2001 45,766 2005 57,300 $ 6,300 12,242 37,508 48,710 54,500 64,859 120,141 142,318 186,905 298,200 Year # of Recipients (m) Total Cost ($m) http://www.cms.hhs.gov/MedicareMedicaidStatSupp/LT/itemdetail.asp?filterType=none&filterByDID=-99&sortByDID=1&sortOrder=ascending&itemID=CMS1213767&intNumPerPage=10 Medicaid Recipients, 2005 http://www.cms.hhs.gov/MedicareMedicaidStatSupp/ (2008 Edition) % of recipients % of payments Average payment Kids( The majority of Other recipients are those with “Permanent and total disability.” .
