Resolution on Improving Quality and Lowering Costs for States Through Medicaid and Managed Care Exposed

The Resolution on Improving Quality and Lowering Costs for States Through Medicaid and Managed Care was adopted by ALEC's Health and Human Services Task Force and approved by the ALEC Board of Directors on September 19, 2010.

ALEC Bill Text

SUMMARY

This resolution encourages the implementation of coordinated, risk-based, capitated programs to control costs and improve quality of care for all Medicaid beneficiaries, including those requiring long-term care services.

RESOLUTION

WHEREAS, Medicaid is an entitlement program jointly funded by the states and the federal government and plays a significant role in state health care systems; and

WHEREAS, Medicaid is the nation’s primary health insurance program for 60 million low income Americans, including nearly 30 million low-income children and 8 million non elderly people with disabilities; and

WHEREAS, Medicaid pays for nearly half of all long-term care in the United States; and

WHEREAS, It is essential that Medicaid achieve transformation to become a sustainable, cost-effective health care program; and

WHEREAS, In most states, costs for the Medicaid program are rapidly growing, claiming an increasing share of state budgets and threatening other state programs; and

WHEREAS, Legislators in all states recognize the important role that Medicaid serves as a provider and purchaser of health care services for vulnerable citizens; and

WHEREAS, Under national health care reform, many states will experience an expansion of persons eligible for Medicaid with many of the attendant cost pressures; and

WHEREAS, The situation for individuals under Medicaid with chronic illness and disabilities is particularly fragmented and uncoordinated, with states spending up to 80 percent of their Medicaid budgets on approximately 20 percent of Medicaid beneficiaries whose needs include long-term care services and supports; and

WHEREAS, Reforming and restructuring state Medicaid programs to provide incentives for high quality, efficient and cost-effective care will help contain the growth of the Medicaid program and help ensure that Medicaid does not threaten other essential state services; and

WHEREAS, Managing the care for those with Medicaid through a risk-based system has demonstrated greater budget predictability, more accountability, improved quality of care for the consumer, and more coordination among service providers.

NOW THEREFORE BE IT RESOLVED that the {insert state legislature} will seek to strengthen the fiscal solvency of {insert state} and improve the health of Americans enrolled in Medicaid by introducing legislation to implement coordinated, risk-based, capitated programs to control costs and improve quality of care for all Medicaid recipients, including those requiring long-term care services.