Private Medicaid expansion could lead to poor outcomes


As states continue to create their own versions of private Medicaid expansion, some advocates believe the approach could inhibit the overall effectiveness of the Medicaid program, Stateline reported. Certain benefits, such as free rides to doctors' offices, typically are not included in private insurance plans.

"Medicaid is different from private insurance for a lot of good reasons," Joan Alker, director of Georgetown University's Center for Children and Families, told Stateline. "Trying to make it look like private insurance without Medicaid's unique features could lead to worse health outcomes, increased hospitalization and more preventable deaths."

Patients with private insurance receive better hospital care than those without it. A study published in Health Affairs last October noted that privately insured patients also had lower mortality rates than those in other payer groups, FierceHealthPayer previously reported.

Back in September, Arkansas was the first state to use Medicaid funds to buy private insurance for consumers eligible for the state-federal health program. Recently, lawmakers in Arkansas renewed the private option. In the state alone, the transportation benefit accounts for $83 million, Stateline reported.

But providing transportation could save states money because it allows patients to see doctors regularly, ultimately avoiding health risks that may require expensive ambulance rides, argued Marsha Simon, president of government relations consulting firm Simon and Company, the article noted.

Nonemergency medical transportation is vital to achieve good health outcomes among Medicaid beneficiaries, according to a March report from Community Transportation Association of America (CTAA), which identified transportation as a major barrier to accessing timely, necessary and continuing medical care.

When the U.S. Department of Health & Human Services approved Iowa's plan last year, it allowed the state to eliminate nonemergency transportation for one year and charge nominal premiums and copays to new enrollees, according to Stateline. Now, other states, including Arkansas and Pennsylvania, want the same terms as Iowa.

To learn more:
- here's the Stateline article
- check out the CTAA report (.pdf)

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