Fortunately, dealing with today’s economic and public health challenges doesn’t have to be a zero-sum game for states. Containing

It’s possible to contain healthcare costs while also maintaining the integrity of healthcare safety net programs. Programmatic improvements, for example, can reduce costs and improve management of population health. These should be the first priority, before implementing more draconian measures like cutting Medicaid enrollment or benefits.

Other strategies include:

  • Restarting and enhancing program integrity initiatives. The current pandemic represents a high-risk period for fraud, waste, and abuse. States should continue and also improve controls designed to protect the sustainability of the Medicaid program, while mitigating the burden of these initiatives on front-line providers.
  • Modernizing Medicaid third-party liability programs. This approach can protect Medicaid as the payer of last resort by strengthening policies and operations, improving efficiencies, and increasing savings and recoveries.
  • Increasing patient engagement and consumerism. Connecting healthcare consumers with helpful information and resources can drive measurable improvements in quality, cost, and outcomes. Targeted communications are one way to direct vulnerable populations to the right types of testing, care, and health resources. Focusing on Medicare beneficiaries in vulnerable racial groups or in communities hard hit by COVID-19, for example, may pay dividends in terms of lower costs and better outcomes.

The COVID-19 pandemic is most definitely a marathon, not a sprint. The coming months will be challenging for states, but there has never been a better time to engage in creative thinking about ways to contain healthcare costs and simultaneously serve the needs of vulnerable citizens. HMS has extensive experience helping states with healthcare cost containment strategies. Visit Health Ideas, our forum to discuss the latest healthcare issues and trends including our newest blog series on cost containment.


Source: Containing Rising Healthcare Costs in the Wake of COVID-19

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