Tags: Obamacare | Medicaid | rising costs | Hennepin County

NYT: States Get Inventive as Medicaid Costs Mount

By    |   Monday, 23 March 2015 03:06 PM

More than 11 million Americans have been added to the Medicaid rolls since the major provisions of Obamacare took effect, and it has left state and local health officials scrambling for ways to contain the soaring costs of providing care to low-income recipients with chronic health problems, The New York Times reported.

Many of these people "are afflicted with some combination of poverty, homelessness, mental illness, addiction and past trauma," the paper said, while noting that a patchwork of experiments across the United States are aimed at finding less expensive ways to provide treatment.

One such effort is taking place in Hennepin County, Minnesota, which includes Minneapolis. The Times tells the story of Jerome Pate, a homeless alcoholic and cocaine addict who made 17 emergency visits in a four-month period last year, earning him a place in the county's experiment to better manage cases like his.

When Pate showed up at the Hennepin County hospital's emergency room last summer complaining of chest pains and harboring thoughts of suicide, a social worker met him in the emergency room and spent close to an hour with him. She found Pate a treatment program and arranged transportation to make sure he arrived there. A doctor later said Pate had a major heart blockage.

Hennepin County's program, run by the county government and a local hospital, is focused on approximately 10,000 people – most of them poor men – who were covered when the state expanded Medicaid under Obamacare. The program is financed through state and federal Medicaid dollars.

The aim is to fix patients' problems before they become expensive medical issues. County social workers help people get telephones and mailboxes and take care of potential problems like unpaid utility bills that could lead to catastrophes such as insulin spoiling in non-working refrigerators. The project also invested funds in a location where drunken patients could sober up instead of receiving treatment in the emergency room.

To persuade it to participate, the state offered the Hennepin County Medical Center a fixed amount per patient, and said the facility could keep the money even if patients used less medical care than was paid for or failed to show up at all.

The pilot program would work on caring for patients in places outside the hospital that are cheaper. While some early experiments have found that these programs save little or no money in the short run, the hope is that some money will be saved in the longer term.

In Hennepin County, medical costs have fallen on average by 11 percent per year since the pilot program began in 2012. Less clear, however, is whether privately run healthcare systems will be as enthusiastic as their public-sector counterparts about the results.

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State and local health officials are scrambling for ways to contain the soaring costs of providing care to low-income recipients with chronic health problems, The New York Times reported.
Obamacare, Medicaid, rising costs, Hennepin County
Monday, 23 March 2015 03:06 PM
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