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Minnesota opts for early expansion of Medicaid
Minnesota faces a projected state budget deficit of $5 billion for the next biennium and increased program enrollment and health care costs in Medical Assistance, Minnesota's Medicaid program, reports David Godfrey, Minnesota state Medicaid director.
Beginning in 2009, payments for specialists and non-primary care providers were reduced by 12%, payments to managed care organizations were reduced by 3%, inpatient hospital rates were reduced by 3%, and pharmacy rates were reduced by 1%, Mr. Godfrey says. Dental services for adults except for pregnant women have been reduced, he adds, and a number of services now require prior authorization.
"The governor has proposed Medicaid surcharges for providers, and payment reduction and reforms, to help balance the state budget," Mr. Godfrey says. "We are examining ways to improve the health care delivery system and payment reform to help contain costs and improve the quality of care."
10,000 uninsured covered
The 2010 Legislature authorized the governor to allow the expansion of Medical Assistance, an option under federal health reform, to adults without children at home with incomes under 75% of the Federal Poverty Level, says Mr. Godfrey.
"The expansion allows the state to provide more comprehensive health care coverage to an estimated 95,000 Minnesotans, and protect 20,000 health care jobs across the state," he says.
The expansion is expected to have a neutral impact on the state budget through state fiscal year 2015, says Mr. Godfrey. The state costs of early expansion are equivalent to the current state cost of providing coverage under two state-funded programs General Assistance Medical Care and MinnesotaCare, he explains, whose enrollees will shift to Medical Assistance.
"The expansion provides federal matching funds of $1.1 billion for the next biennium," says Mr. Godfrey. It also generates cost savings for the state, by reducing the projected shortfall in the Health Care Access Fund by $500 million, he adds.
Mr. Godfrey estimates that 85,000 people covered by the expansion were covered under state-funded programs, and will now receive more comprehensive care with lower co-pays. An estimated 10,000 who will now be covered under Medical Assistance were uninsured, notes Mr. Godfrey.
"The expansion is expected to benefit the state overall, by reducing the number of people who do not have health care coverage and uncompensated care costs," he explains.
Governor Mark Dayton, who took office January 1 of this year, signed the executive order implementing Minnesota's early Medicaid enrollment on January 5 for implementation by March 1, reports Mr. Godfrey. "The rapid timetable to implement the expansion in two months has been a challenge," he says.
The implementation involved policy development, system changes, worker training and communications with clients, workers, providers, and other stakeholders, he says, as well as securing federal approval. State and county workers, health care providers, and other stakeholders worked to quickly implement the expansion, he adds.
"The expansion was the department's number-one priority," says Mr. Godfrey. "That work was done first and resources were supplied."
Minnesota's Department of Human Services did some preliminary planning prior to the executive order, says Mr. Godfrey, then established a departmentwide team that worked on all of the various areas. "The implementation began on schedule," he reports. "We are on track with case conversions."