Medicaid

MedicaidAmerican health care stands in the crossroads of epic change, and Medicaid is right at the center of it all. Medicaid funds about two-thirds of all mental health care in the United States. The program has grown enormously since its inception in 1965. And its growth is about to explode. In January 2014, a major provision of the The Patient Protection and Affordable Care Act (“Obamacare” will expand the Medicaid roles by 25% almost overnight, while doing nearly nothing effective to increase the number of providers serving Medicaid patients. For loved ones with psychiatric disabilities whose health care is funded by Medicaid and their families , this expansion has enormous implications.

Because of the grave importance of Medicaid’s changes, PsychOdyssey is pleased to establish this new Research… page specially dedicated to Medicaid information.

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Doctors brace for pain as 10% cut to Medi-Cal rates looms.

Los Angeles Times, June 11, 2013

 

Los Angeles TimesIn a office decorated with Chinese art and diagrams of body parts, Dr. George Ma cares for more than 4,000 patients.Nearly three-quarters are covered by Medi-Cal, the state’s public insurance program for low-income Californians, and Ma said he receives $10 a month to treat most of them.This summer, when California makes a controversial 10% cut to Medi-Cal rates, he could get paid less. Ma said he didn’t go into safety net medicine for the money, but he worries that the reductions will make it even harder for his patients to get medication, medical equipment and appointments with specialists.

The reductions to providers like Ma will also create a massive glitch in the implementation of national healthcare reform — the cuts to Medi-Cal rates are to occur just as more people prepare to join the program under the Affordable Care Act. Currently 8.3 million poor Californians are covered by Medi-Cal, and more than 1 million new enrollees are expected beginning next year. [Read more…]

 

Will Medicaid’s 3 Big Changes Improve Recoveries of Adults with Schizophrenia in New Jersey?

 PsychOdyssey Research, May 28, 2013

In the face of enormous changes to Medicaid mandated for New Jersey, PsychOdyssey studied the likely impact on those with psychiatric disabilities in the Garden State. The 64 page academic paper (with 80 cited references) provides an exhaustive look at Medicaid managed care as it is to be undertaken in New Jersey. From the abstract:

Implementation of the 2010 Patient Protection and Affordable Care Act will bring 3 big changes to New Jersey’s Medicaid system very soon and very nearly at once.  The changes are managed care, expansion, and reform. Will they improve the recoveries for New Jersey Medicaid beneficiaries with schizophrenia?

This paper considers five change domains by which to classify and evaluate elements of the coming changes to New Jersey Medicaid. It reviews the requirements of care for schizophrenia, parameters of recovery from schizophrenia, outcomes and measures of progress with schizophrenia, and the Medicaid system today that funds treatments of schizophrenia. It then examines the elements of Medicaid’s three major changes as they relate to New Jerseyans with schizophrenia. Finally, referencing several research articles, it analyzes the likely effects of these changes to see if they will improve the recoveries of New Jerseyans with schizophrenia. The paper considers these things from the viewpoints of enrolled, soon to be enrolled and not to be enrolled New Jerseyans with schizophrenia.

The paper concludes that Medicaid’s 3 big changes in general will not improve recoveries of New Jerseyans with schizophrenia, although it acknowledges that those soon to be enrolled because of Medicaid expansion will be better off than they would be uninsured. But neither will the changes necessarily worsen recoveries. The author concludes that Medicaid’s 3 big changes were never about improving recoveries, or even about improving the behavioral health system, and laments that the Patient Protection and Affordable Care Act missed a rare opportunity for major reform of behavioral health care in America.

To read PsychOdyssey’s research paper, Will Medicaid’s 3 Big Changes Improve Outcomes of Adults in New Jersey with Schizophrenia?, click here.

 

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