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Medicaid reform: programming solutions to the equity problem.

B Stuart, E Reutzel, T Reutzel

    Journal of Health Politics, Policy and Law
    |January 1, 1985
    PubMed
    Summary
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    This study applies mathematical programming to Medicaid reform, estimating fund redistribution for equitable eligibility and benefits. Results show actuarial and efficiency factors explain most spending differences, not equity gaps.

    Area of Science:

    • Health Economics
    • Public Policy Analysis
    • Mathematical Modeling

    Background:

    • Medicaid reform debates involve significant policy challenges.
    • Achieving equitable eligibility and benefit coverage across states remains a key issue.
    • Interstate disparities in Medicaid spending require thorough investigation.

    Purpose of the Study:

    • To apply a mathematical programming model to the Medicaid reform debate.
    • To estimate achievable equity in the current Medicaid system under constraints.
    • To analyze interstate spending differences for aged recipients of Supplementary Security Income (SSI).

    Main Methods:

    • Development and application of a mathematical programming model.
    • Simulation of two scenarios using 1979 data for aged SSI recipients.

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  • Analysis of factors contributing to interstate spending variations.

    • Main Results:

    • Mathematical programming can model Medicaid fund redistribution for equity.
    • Actuarial and efficiency factors account for at least half of interstate spending differences.
    • Remaining differences suggest potential for equity improvements.

    Conclusions:

    • Medicaid spending disparities are influenced by factors beyond equity.
    • Policy interventions can address remaining equity gaps in Medicaid.
    • Further research should explore implications of eliminating residual spending differences.