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A look at Washington state's Medicaid program could provide some clues for how to control costs as states prepare for the massive 2014 expansion of Medicaid under the Affordable Care Act.
Washington has been able to provide widespread access to outpatient services and prescription drugs, while keeping down spending on inpatient care (Health Aff. 2011;DOI:10.1377/hlthaff.2011.0106).
The per beneficiary cost for inpatient stays was about 35% below the national average in Washington state, while outpatient visits and prescriptions were each 15% above the national average, wrote Todd P. Gilmer, Ph.D., and Richard G. Kronick, Ph.D., of the University of California, San Diego. (Dr. Kronick is now a deputy assistant secretary for health policy at the Department of Health and Human Services.)
The authors analyzed Medicaid claims data from 2001-2005 to see how the volume and the price of services affected the variation in spending across the states. “Several states are using their Medicaid resources in a way that's helping to reduce the need for more expensive hospital care,” Dr. Gilmer said in a statement. “By increasing access to primary care and experimenting with team-based delivery models and low-cost providers, states may be able to improve quality while reducing Medicaid spending.”
For example, the programs in Connecticut, Massachusetts, New Hampshire, and Vermont spent more than most on prescription costs and outpatient visits, but had a lower-than-average number of hospital days. The inpatient and outpatient spending offset each other, such that average overall spending was just below the mean of all states.
The researchers also found that having a large primary care workforce was associated with reduced hospital stays for diabetes.
The authors received funding from the Robert Wood Johnson Foundation's Changes in Health Care Financing and Organization initiative.
A look at Washington state's Medicaid program could provide some clues for how to control costs as states prepare for the massive 2014 expansion of Medicaid under the Affordable Care Act.
Washington has been able to provide widespread access to outpatient services and prescription drugs, while keeping down spending on inpatient care (Health Aff. 2011;DOI:10.1377/hlthaff.2011.0106).
The per beneficiary cost for inpatient stays was about 35% below the national average in Washington state, while outpatient visits and prescriptions were each 15% above the national average, wrote Todd P. Gilmer, Ph.D., and Richard G. Kronick, Ph.D., of the University of California, San Diego. (Dr. Kronick is now a deputy assistant secretary for health policy at the Department of Health and Human Services.)
The authors analyzed Medicaid claims data from 2001-2005 to see how the volume and the price of services affected the variation in spending across the states. “Several states are using their Medicaid resources in a way that's helping to reduce the need for more expensive hospital care,” Dr. Gilmer said in a statement. “By increasing access to primary care and experimenting with team-based delivery models and low-cost providers, states may be able to improve quality while reducing Medicaid spending.”
For example, the programs in Connecticut, Massachusetts, New Hampshire, and Vermont spent more than most on prescription costs and outpatient visits, but had a lower-than-average number of hospital days. The inpatient and outpatient spending offset each other, such that average overall spending was just below the mean of all states.
The researchers also found that having a large primary care workforce was associated with reduced hospital stays for diabetes.
The authors received funding from the Robert Wood Johnson Foundation's Changes in Health Care Financing and Organization initiative.
A look at Washington state's Medicaid program could provide some clues for how to control costs as states prepare for the massive 2014 expansion of Medicaid under the Affordable Care Act.
Washington has been able to provide widespread access to outpatient services and prescription drugs, while keeping down spending on inpatient care (Health Aff. 2011;DOI:10.1377/hlthaff.2011.0106).
The per beneficiary cost for inpatient stays was about 35% below the national average in Washington state, while outpatient visits and prescriptions were each 15% above the national average, wrote Todd P. Gilmer, Ph.D., and Richard G. Kronick, Ph.D., of the University of California, San Diego. (Dr. Kronick is now a deputy assistant secretary for health policy at the Department of Health and Human Services.)
The authors analyzed Medicaid claims data from 2001-2005 to see how the volume and the price of services affected the variation in spending across the states. “Several states are using their Medicaid resources in a way that's helping to reduce the need for more expensive hospital care,” Dr. Gilmer said in a statement. “By increasing access to primary care and experimenting with team-based delivery models and low-cost providers, states may be able to improve quality while reducing Medicaid spending.”
For example, the programs in Connecticut, Massachusetts, New Hampshire, and Vermont spent more than most on prescription costs and outpatient visits, but had a lower-than-average number of hospital days. The inpatient and outpatient spending offset each other, such that average overall spending was just below the mean of all states.
The researchers also found that having a large primary care workforce was associated with reduced hospital stays for diabetes.
The authors received funding from the Robert Wood Johnson Foundation's Changes in Health Care Financing and Organization initiative.
From Health Affairs