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Written by: Michael Bolton on Monday, March 28, 2011 Posted in:

Today’s Wall Street Journal features a case study on Rhode Island’s efforts to manage its Medicaid Waivers program – Rhode Island’s Medicaid Lesson: A Case Study in How Waivers for State Innovation Can Work.

The case study highlights Rhode Island’s work to get a block Medicaid Waiver grant with a global expense cap of $12.075 billion over five years from the federal government in exchange for freedom to reform the state’s Medicaid program as they saw fit.

According to the Wall Street Journal, Medicaid spending in Rhode Island dropped to $2.7 billion instead of increasing to $3.8 billion as projected.  The state accomplished this by letting seniors move from nursing homes into home- and community-based care, and, more specifically, by establishing:

  • wellness programs,
  • co-payments,
  • audits of hospitals and nursing homes, and
  • fraud prevention programs.

Proponents of this approach believe that efforts to move seniors from nursing homes to home- and community-based settings has greatly improved the quality of care seniors are getting.  Others favor the approach because, quite simply, by providing flexibility to adjust and reform the program, the State is saving money.

As states look to find ways to reduce Medicaid costs, many will look to Rhode Island’s example to provide better quality of care for less.

Read the complete story in the Wall Street Journal here.