Congress Should Improve Continuity of Coverage and Quality of Care for Medicaid Beneficiaries
Request
To protect Medicaid beneficiaries, ACAP urges the Congress to support legislation that will significantly reduce “churn” for people who are Medicaid-eligible and improve quality of care for all Medicaid beneficiaries, regardless of whether they are receive benefits through fee-for-service, primary care case management, or managed care programs.
ACAP is interested in working with members of Congress to introduce legislation to address these important issues.
Background
Medicaid is the backbone of health care for the poorest and most medically needy Americans. Currently, over 47 million Americans rely on Medicaid to receive their health care. Both the House of Representatives’ and Senate health care reform bills would significantly expand Medicaid to cover every American below 150 and 133 1/3 percent of the federal poverty level.
However, Medicaid suffers from a significant problem known as “churn,” whereby enrollees are continuously disenrolled and re-enrolled for Medicaid, regardless of actual eligibility status. Many of these individuals suffer from a lack of coverage in the interim. As a recent study by the George Washington University states:
“… Medicaid enrollment is like a leaky sieve; every year millions of people enroll, only to subsequently lose their coverage, despite still being eligible, because of inefficient and cumbersome paperwork requirements. The interruptions in coverage affect the continuity and effectiveness of health care received. Interruptions also impair quality monitoring and improvement activities because many Medicaid enrollees were not enrolled long enough to assess the quality of their care… Improving retention in Medicaid is a cost-effective way to reduce the number of uninsured people, make their health insurance coverage more secure, improve the measurement of health care quality, and ultimately improve people’s health.”
In addition, George Washington University finds that “Federal law already requires various quality monitoring and improvement processes for capitated managed care organizations in Medicaid, which serve just under half of all enrollees. However, for the majority of Medicaid enrollees, who are served by Primary Care Case Management or fee-for-service arrangements, including many of those with the most severe health needs, there are no federal requirements for comparable quality monitoring or improvement.” ACAP urges Congress to ensure that all Medicaid beneficiaries, regardless of how they receive care, are protected by a standard set of quality measures.
ACAP looks forward to working with Congress to introduce legislation to address these important continuity and quality issues for Medicaid beneficiaries.
Congress Should Improve Continuity of Coverage and Quality of Care for Medicaid Beneficiaries
Request
To protect Medicaid beneficiaries, ACAP urges the Congress to support legislation that will significantly reduce “churn” for people who are Medicaid-eligible and improve quality of care for all Medicaid beneficiaries, regardless of whether they are receive benefits through fee-for-service, primary care case management, or managed care programs.
ACAP is interested in working with members of Congress to introduce legislation to address these important issues.
Background
Medicaid is the backbone of health care for the poorest and most medically needy Americans. Currently, over 47 million Americans rely on Medicaid to receive their health care. Both the House of Representatives’ and Senate health care reform bills would significantly expand Medicaid to cover every American below 150 and 133 1/3 percent of the federal poverty level.
However, Medicaid suffers from a significant problem known as “churn,” whereby enrollees are continuously disenrolled and re-enrolled for Medicaid, regardless of actual eligibility status. Many of these individuals suffer from a lack of coverage in the interim. As a recent study by the George Washington University states:
“… Medicaid enrollment is like a leaky sieve; every year millions of people enroll, only to subsequently lose their coverage, despite still being eligible, because of inefficient and cumbersome paperwork requirements. The interruptions in coverage affect the continuity and effectiveness of health care received. Interruptions also impair quality monitoring and improvement activities because many Medicaid enrollees were not enrolled long enough to assess the quality of their care… Improving retention in Medicaid is a cost-effective way to reduce the number of uninsured people, make their health insurance coverage more secure, improve the measurement of health care quality, and ultimately improve people’s health.”
In addition, George Washington University finds that “Federal law already requires various quality monitoring and improvement processes for capitated managed care organizations in Medicaid, which serve just under half of all enrollees. However, for the majority of Medicaid enrollees, who are served by Primary Care Case Management or fee-for-service arrangements, including many of those with the most severe health needs, there are no federal requirements for comparable quality monitoring or improvement.” ACAP urges Congress to ensure that all Medicaid beneficiaries, regardless of how they receive care, are protected by a standard set of quality measures.
ACAP looks forward to working with Congress to introduce legislation to address these important continuity and quality issues for Medicaid beneficiaries.