The healthcare reform bill that extends Medicaid eligibility may have been passed only last March, but a new report suggests that enrollment as well as health plans that administer the program already grew substantially in 2009.
Released by the Centers for Medicare and Medicaid Services (CMS), the report showed that Medicaid health plan enrollment increased by nearly 2.4 million individuals in 2009, and the program currently covers more than 23 million Americans.
Moreover, the study found that while the ranks of Medicaid recipients expanded by 7 percent between June 2008 and June 2009, Medicaid programs saw more than 11 percent growth during that same time, regardless of their size, ownership or financial status.
This means that nearly half (47 percent) of all Medicaid beneficiaries are enrolled in a health plan, and some 72 percent participate in some form of managed care.
The report also estimates that starting in 2014, when most of the provisions of the healthcare reform bill will come into effect, Medicaid ranks will grow by between 16 and 24 million.
In response to these results, Medicaid Health Plans of America (MHPA) – a nonprofit trade association that provides advocacy, research and forums that support policy to promote and enhance the delivery of quality care, has said that the industry is prepared to absorb most of the new members.
"States are increasingly turning to Medicaid health plans to manage benefits in their Medicaid programs," said MHPA president and CEO Thomas L. Johnson.
He added that it is because "they understand the benefits of health plans in coordinating care and improving quality, which allows for the provision of Medicaid benefits at a lower, more predictable cost than fee-for-service traditional Medicaid."
Medicaid is a social safety program designed to provide access to medical care to eligible individuals and families from low-income backgrounds as well as veterans and children covered by the Children’s Health Insurance Program.
By 2014, states will begin to expand eligibility for Medicaid to include non-pregnant adults under 65 years of age as well as individuals under 65 who are not eligible for Medicare, and whose income is the same or less than 133 percent of the poverty level. Moreover, the application process for Medicaid will be simplified and electronic.
All of these trends should be of great interest to healthcare providers and facilities that serve these populations. They also serve to emphasize the importance of switching to properly certified electronic health records (EHRs) and applying them in such a way that they meet the ‘meaningful use criteria.’ In turn, this will make the providers eligible for incentive payments from the CMS, as stipulated in last year’s American Recovery and Reinvestment Act.
The report also comes shortly after President Obama appointed Dr Donald Berwick – a Harvard graduate, pediatrician and CEO of the Institute for Healthcare Improvement – as the head of the CMS.
Berwick, who was appointed through the controversial process as Congress was on recess, has a reputation for supporting government intervention in the healthcare sectors. However, industry groups such as The American Hospital Association and the Federation of American Hospitals have praised Obama’s choice, saying Berwick "will bring a wealth of knowledge and practical experience to CMS from his perspective as a physician, teacher and passionate advocate for high-quality care," according to media reports.
Medicaid was established on July 30, 1965, through Title XIX of the Social Security Act. The original act, which was passed in 1935, also set up Medicare, which provides government-run healthcare plan for aged and disabled individuals. 