Can we avoid 70% of the cost of the huge Medicaid expansion within ObamaCare?. Yes, says a careful analysis, from a very knowledgeable source with practical experience.
Between 2014-2019, the estimated additional cost of the Medicaid expansion within ObamaCare, that accounts for over half those with added coverage, is $436.4 billion. That’s the figure analyzed by United Healthcare’s Center for Health Reform and Modernization. That ranges from $12.2 billion for Alabama, to $32.4 billion for California, to $28.1 billion for Florida, to $19.5 billion for Georgia, to $12.6 billion each for Indiana and Illinois, to $10.7 billion for Michigan, to $2.8 billion for Nevada, to $16.6 billion for Ohio, to $27.4 billion for Pennsylvania, to $59.5 billion for Texas, to $13 billion for Virginia.
The magnitude of each state’s added cost varies with how liberal its qualifications are already. Another factor is who gets new coverage.
Of the 16.4 million, 13.2 million are adults without dependent children. The first nine years of expanded coverage will, also, lead to high claims costs: In the first three years of new coverage, claims costs are estimated to be 3X average, in the next three years about 1.8X average, in the next three years about 1.2X average.
Sixty-seven percent of primary care doctors expect there to be a shortage of doctors to treat the new Medicaid patients. In California, the percentage rises to 88%, in Florida 90%, in Texas 97%.
However, 49% of primary care doctors believe there would be greater willingness and ability to take care of new Medicaid patients if its reimbursement rates, now well lower than Medicare’s, up to 50% lower, were increased to par with Medicare. 81% believe that more access would be available if Medicaid reimbursement rates were on par with the discounts given to commercial insurers. So, look for the another huge increase in Medicaid costs, $63 billion to reach par with Mediacre rates, far more to reach insurer rates, no where to be found in the rosy static estimates issued by the CBO for ObamaCare. On the other hand, the rest of primary care doctors are already stretched as far as they can. Thus, still, likely large, shortages of care. A new benefit without a benefit.
United’s experience and analysis comes up with $366 billion that can be pared from the added bill for Medicaid.
Coordinated Care, Managed Care: Higher levels of care via HMO-like plans saves $93 billion. That’s $12.2 billion in California alone, $3.4 in Florida, $3.8 in Illinois, $2.6 in Massachusetts, $11.2 in New York, $3.4 in Ohio, $5.8 in Texas, $1.1 in Virginia, $2 in Washington.
Better Long Term Care for Seniors and Disabled: This 15 million of the Medicaid population generate near 65% of Medicaid’s spending. Increase preventive and pre-crisis care. Increase supported home and community-based instead of institutional care. Integrate levels of care and caregivers. Save $140 billion.
Modernize Administration: IT systems. Electronic claims, validated before payment to prevent waste and frauds. Unify programs. Predictive modeling to ID those with potential high risks, to head them off. Save $133 billion, including $96 billion of medical spending.
Voila! $366 billion saved, or rather avoided. Some of these savings could be channeled into providing primary care doctors with a living wage for the living patients.
Chances? Only some of this spending avoidance will be realized, due to interference by bureaucratic fiefdoms and administrators who currently benefit from excessive and sloppy spending. Unless we the taxpayers demand better, for those cared for and for ourselves. Unless the newly covered demand reasonable access to reasonable care.
Tracked: Apr 16, 16:40