Word: medicaid
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...MATTER WHOSE PLAN WINS in Washington, the current Medicaid program is history. And in 11 states its future has arrived. While still collecting federal money, these states have designed their own health-care systems for their poor and elderly populations. A close look at two of them illustrates the difficulties of the job. Arizona's plan, in place since 1982, is hailed as a model of managed care, while TennCare, started in 1994, is still locked into a troubled and controversial infancy. Both offer visions of what may be facing all states in the lean times ahead. Their stories...
...mainstreaming of Medicaid, where low-income patients receive the same care from the same physicians as their better-off peers, is only one of the successes of Arizona's system. The most remarkable thing is that the state government managed to come up with a program that makes just about everybody happy: the patients, the doctors, the bureaucrats and the number crunchers. ahcccs, a managed-care system in which health-care providers enter an intensely competitive auction to win state contracts, serves some 455,000 patients, almost all of whom would be eligible for Medicaid. (Total budget this year...
Arizona seized an opportunity no longer open to the rest of the country: the state never had an entrenched Medicaid system in place. By 1982, though, county governments were going broke struggling to provide indigent health care. The state decided it needed a piece of the federal Medicaid pie but not under the standard federal conditions. Arizona legislators took their state's clean slate and drew up their own blueprint for a Medicaid system...
...care ratios, the computer turned out to be an expensive but ultimately efficient secret to the program's success--but one that other states will be hard put to duplicate with fewer federal dollars. Although ahcccs' administrative costs are higher than those in states that operate under a traditional Medicaid system, Arizona is still saving money. According to a report by the General Accounting Office (gao), Arizona is saving 7% a year on acute care and 16% on long-term care, compared with a similar program in neighboring New Mexico, a state with comparable demographics...
This long-term-care program also serves about 11,000 elderly people, either in their homes or in nursing care. Many of these people, like Medicaid recipients around the country, may have saved for their retirement, but their care remains either unaffordable or unmanageable. Lois Horn neglected her now bankrupt lamp business to care for her aging mother until the burden became too much. The 89-year-old mother currently lives, wheelchair bound and dementia-stricken, in the Carondelet Holy Family Center in Tucson, which costs more than $3,000 a month. "We don't have the money...