In 2008, Rhode Island received $12 billion – capped – to spread over 5 years, to make changes to its Medicaid programs. In a story titled “Rhode Island’s Medicaid Gamble”, Stateline.org reports that critics called the spending cap “a dangerous precedent” and “a radical and risky departure from the way Medicaid currently operates.” The fear was that the state would run out of money. Patient advocacy groups feared the state would cut benefits, restrict treatments, push people onto waiting lists or drop coverage in order to balance the budget, as it chose.
Rhode Island’s “gamble” has actually helped save the cash-strapped state millions of dollars. And, most important of all, hundreds of the state’s most vulnerable residents are getting care in their homes or in assisted-living centers, rather than the more costly nursing homes, where few people want to be, but where Medicaid typically places them.
According to the Stateline.org story, 100 Rhode Islanders who had been in nursing homes are receiving care in community settings, and another 200 are getting Medicaid-funded home-based help that the state and federal government previously would not have paid for. The state is testing whether this will save more money in the long run by delaying or even preventing seniors’ need to be put under nursing home care at all.
There are still many questions and concerns about viability of the program. Will the state be able to continue to pay for it? Will new federal healthcare reform limit the impact of their efforts? The jury is still out, but for now, Rhode Island is enjoying the benefit of saving money and providing higher quality care to its aging senior population.