States Medicaid systems in modern mode
April 9, 2013 in Medical Technology
Since 2007, and in the wake of the Great Recession, an additional 10 million Americans have enrolled in Medicaid, at the same time that states’ tax revenue declined.
But those long-plagued by Medicaid debt are starting to address their problems, several states are forging ahead with accountable care innovations and the consumer experience is becoming an increasingly important point of focus.
Indeed, states including Illinois, Colorado, Utah and Oregon, among others, are modernizing their systems to both embrace flavors of accountable care and drive patient empowerment.
Medicaid issues in Illinois have been exacerbated by outdated Medicaid information systems, a lack of care coordination and long-running public financing problems.
Facing some $2.3 billion in unpaid Medicaid bills, on top of several billion in budget shortfalls and almost $100 billion in long-term unfunded public pension obligations, Illinois is perhaps the most striking example of Medicaid’s challenges — and the need for digital health technologies and consumer-focused services.
Although not as sweeping as state budget hawks would prefer, Illinois’ 2011 Medicaid reform law, in tandem with its budding statewide health information exchange, should go at least some way to crafting a more sustainable safety net program that reduces financial chaos for providers while improving patient experiences and outcomes.
By 2015, under the 2011 law, at least 50 percent of Illinois’ approximately 2.7 million Medicaid patients have to be in some form of integrated, managed or coordinated care, while the amount of year-over-year Medicaid carry-over debt is being limited to $700 million this year and $100 million in 2014. By June 30, 2014, Governor Pat Quinn is proposing to have all of the state’s current Medicaid debt paid off.
In the long-term, the Illinois Health Information Exchange (ILHIE) is going to be one of the main tools making that all possible by empowering clinical care teams and helping reduce administrative waste. Led by Ivan Handler, CTO of the Illinois Office of Health Information Technology, ILHIE is being developed as a quasi-public utility that will offer providers cloud-based exchange and care management solutions.
“Significant numbers of providers have already converted and are beginning to explore inter-connectivity outside their walls,” Handler said. “This process needs to continue and accelerate. After information is digital, everything else can begin to happen. Population health and preventive disease management should be an ultimate goal to strive for.”