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State Medicaid reform under Section 1115 demonstration authority
Health Care Law Newsletter
|October 5, 1995
Summary
States seek Section 1115 waivers for Medicaid reform. Evaluating managed care projects helps assess cost control, efficiency, and capitation rates for federal Medicaid funding and state flexibility.
Area of Science:
- Health Policy
- Healthcare Management
- Public Health
Background:
- Federal Medicaid law presents complexities and limits state flexibility.
- States frequently request Section 1115 waivers for healthcare reform initiatives.
- Existing Section 1115 projects with statewide managed care are crucial for evaluating reforms.
Purpose of the Study:
- To assess the utility of Section 1115 waiver projects in evaluating Medicaid reform.
- To examine how these projects inform discussions on federal Medicaid funding and state-level changes.
- To analyze the impact of managed care on cost control and efficiency in Medicaid programs.
Main Methods:
- Analysis of operational Section 1115 projects focusing on statewide managed care systems.
- Evaluation of Medicaid reform measures discussed at state and federal levels.
- Assessment of cost control and federal dollar utilization within these projects.
Main Results:
- Section 1115 projects provide valuable data for evaluating Medicaid reform.
- Managed care systems show potential for controlling Medicaid and indigent care costs.
- Project results are important for assessing block grant approaches and capitation rate methodologies.
Conclusions:
- Section 1115 waivers are vital for state Medicaid innovation and reform.
- Managed care arrangements are key to improving Medicaid program efficiency and cost-effectiveness.
- Findings from these projects inform future federal and state Medicaid policy decisions.