Report concludes private-Medicaid doable, but costs uncertain
While federal Medicaid officials could be amenable to such a plan,
Additionally, the state would probably need to bring at least one other private insurer -- and competition -- into the individual health insurance market to gain CMS approval, it states.
Currently,
Under the private-Medicaid concept, a group of relatively low-utilization Medicaid recipients would be moved to private insurance plans and the state would subsidize the premiums and other out-of-pocket expenses paid by those individuals.
A new "reference-based pricing" mechanism would be necessary to curb reimbursement costs for procedures paid for by the state through a private insurer that were previously paid at Medicaid rates.
According to
To counter that, state officials could implement reimbursement rates specific to the Medicaid population moved to private insurance, according to the report, but also not without potential consequences.
"In selecting targeted (reference-based pricing) reimbursement rates,
A 2016 study, known as the Milliman report, and done when state lawmakers were debating a suite of Medicaid reforms, concluded that shifting low-income adults enrolled under expanded Medicaid coverage to the individual private insurance market would cost the state an additional
The contract for the Medicaid analysis was for up to
DHSS officials requested the report this past spring, which was obtained by the Journal
Many legislators were critical of the veto because short-funding the program on the front end without major changes to Medicaid will likely necessitate supplemental appropriations later in the fiscal year -- a scenario that has played out in recent years.
While overall Medicaid spending in
The Dunleavy administration has also suggested shifting the state's federal Medicaid funding to block grants as a way to limit overall costs.
Doing so could also help the state offset any extra costs from the private insurance option by using a portion of the expected federal savings to cover higher reimbursement rates, according to the report.
Any such changes to
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