Back on Track

We are back on track, discussing the improvement of Medicaid for both patients and providers.

Section 2701 sets up an adult health quality measurement process, complete with reports! The details of the quality measurements are not set forth here, but will be the first task undertaken by these people.

Section 2702 is a little weird. It identifies states that prohibit payments under Medicaid for health-care acquired conditions and then doesn’t pay the states for those conditions as well. So if you get sick, and whatever care you get leads to preventable condition, your provider won’t be paid for your initial care. The incentives there are a little weird – enough doctors don’t take Medicaid patients as it is and this seems like it would increase that number. I guess we will have to see.

Section 2703 allows the state to create “care homes” for chronic conditions. These aren’t physical homes, but rather designated care teams that can coordinate between multiple providers, and potentially improve health.

Section 2704 provides money to test out the use of bundled payments for hospitalization. That is, if you go into the hospital, they would get a single payment, no matter how much that “care episode” cost. Presumably this would create an incentive to improve quality of care.

Section 2705 tests out another type of payment system – a global capitated system, rather than fee-for-service – specifically for large safety-net type hospitals.

Section 2706 introduces the accountable care organization, similar to the care homes in section 2703, for pediatric care.

Section 2707 is another demonstration project, such as 2703, 2704, 2705, and 2706. This one is for private hospitals for psychiatric care.

Tomorrow – more improvements!


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