Briefs & Reports

Politics, budgets and reform pummel state Medicaid programs

Joan Henneberry

State Medicaid directors are caught in the vice grip of competing interests driven by the looming election, lean state budgets, uncertainty about expansion caused by the Supreme Court health reform decision and the threat that Congress will cut the health program to help balance the federal budget.

At the same time, Medicaid directors have an opportunity to make significant changes away from the traditional fee-for-service care delivery and payments that will ripple throughout the healthcare system, according to Matt Salo, executive director of the National Association of Medicaid Directors.

Medicaid directors are “trying to do the herculean, Manhattan Project-style effort to totally reform the healthcare system without enough time, enough money, enough staff or enough people out there even aware of what they’re doing,” he said.

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