Reebok Khaki Green

Reebok Khaki Green

Reebok Khaki Green

individuals that should not be covered? Second, is the program budget growing too rapidly, requiring Saucony Black And Teal

Reebok Khaki Green

Reebok Khaki Green

Considering the first question, if the belief is that North Reebok Suede Blue

Reebok Khaki Green

Carolina's Medicaid program is just too big and inappropriately draining state resources, then the Legislature has several options for a quick fix. First, eliminate or modify eligibility classifications to the extent allowable under federal law. Second, eliminate or modify the service array to the extent allowable under federal law. Third, reduce the rates paid to health care providers for Medicaid covered services.

that growth be curtailed? Answering these questions will provide guidance toward what our Medicaid reform approach and budget goals should be.

Many believe that the easy thing to do is just pay the health care providers less. To gain federal approval, the State has to prove that the reduction in provider rates will not negatively impact access to services and rates will reasonably cover the cost to provide the scope of service. As rates are consistently reduced to achieve budget goals, the question of maintaining access begins to be more difficult to answer. Many health care providers with high overhead costs for staffing (often times under regulatory mandates) and facilities are challenged to maintain quality of care and retain necessary qualified staff. As rates are reduced, providers must evaluate the feasibility of continuing to provide services to Medicaid consumers or, in some cases, whether to continue providing services at all.

There are two fundamental questions that must be answered if we are going to achieve successful Medicaid reform. First, is the program budget too expensive because the existing program offers too broad an array of services or provides coverage to Reebok Classic Leather White Gum

Throughout this discussion we must remember that, like it or not, health care is a significant portion of our economy and jobs in North Carolina. Health care is among the top five employers in 64 of the state's 100 counties. Health care spending is almost 18 percent of our nation's Gross National Product. While Medicaid covers only about 16 percent of the Reebok Khaki Green state's population, significant changes in the program can create ripples throughout the health care delivery system that can impact more than just Medicaid consumers.

Part two of a two part guest commentary

Reebok Khaki Green

Reebok Khaki Green

Much of the Medicaid reform discussion has revolved around the budget issues faced during the 2013 Legislative session. There is a difference between Medicaid program growth and the state's Medicaid budget. The federal participation percentage is not stagnant, but goes up and down with the state's economy. When the economy is bad, the federal government pays a greater percentage of the cost. When the economy improves, federal funds decline. With this last budget, a substantial part of increased Medicaid cost to the state was filling in the budget hole left by declining federal participation in program funding. This budgeting issue is not one that will be solved through the way we manage care. This issue is one that will reoccur each time we move from a bad economy to a good economy unless the Legislature takes a different approach in determining the Medicaid budget during bad economic times.

To the second question, if the belief is that the program budget is growing too fast, then the state should decide what is an acceptable rate of program growth considering the state's expanding population as well as the growing cost of technology, medical advances, and other costs of care. Perhaps a good goal for future Medicaid growth would be to work to maintain program increases at some percentage less than the annual growth rate of the state's General Fund. By setting and achieving this goal, we would year by year reduce the percentage the Medicaid budget consumes of the general fund.

Reebok Khaki Green

Reebok Khaki Green

´╗┐State decisions needed on Medicaid funding

None of these options come without negative impacts on the population served by Medicaid or the health care providers, nor do they come easy politically. As a result, for almost 20 years, as the discussion and debate about long term sustainability of the program continued, these options were reviewed almost annually with no substantial action taken by the Legislature to modify the program.

Reebok Khaki Green

Reebok Khaki Green

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