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Restoring fiscal integrity to medicaid financing?
Teresa A Coughlin1, Stephen Zuckerman, Joshua McFeeters
1Urban Institute, Washington, DC, USA. tcoughli@ui.urban.org
Health Affairs (Project Hope)
|September 13, 2007
Summary
States increased Medicaid supplemental payments (SPs) like disproportionate-share hospital (DSH) and upper payment limit (UPL) using general funds. Despite federal reforms, further changes in state Medicaid financing are needed.
Area of Science:
- Health Policy
- Healthcare Finance
- Public Health
Background:
- Medicaid supplemental payments (SPs) are crucial for healthcare financing.
- Disproportionate-share hospital (DSH) and upper payment limit (UPL) are key SP mechanisms.
- Understanding trends in SPs is vital for healthcare policy analysis.
Purpose of the Study:
- To analyze Medicaid supplemental payments in 2005.
- To examine changes in DSH and UPL payments from 2001 to 2005.
- To assess the impact of federal reforms on state Medicaid financing.
Main Methods:
- Utilized survey data for analysis.
- Examined financial data for Medicaid supplemental payments.
- Compared payment data between 2001 and 2005.
Main Results:
- States increased reliance on general funds for DSH payments.
- Significant expansion in the size and scope of other SPs observed.
- Identified shifts in Medicaid financing strategies by states.
Conclusions:
- Federal efforts to reform state Medicaid financing show some progress.
- States continue to expand supplemental payment programs.
- Further federal action is necessary to refine state Medicaid financing.
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