Restructure Medicare & Medicaid: Policy Option #4
Reducing Optional Services + Optional Beneficiary Groups' Could Save Up to ~60% of Annual Medicaid Cost, per Kaiser Family Foundation
Note: 1) Medicaid is a jointly financed federal and state program that provides health and long-term care services to 55 million low-income Americans. As a
condition of participating in Medicaid, states are required to cover certain “mandatory” populations and to provide a specified set of benefits. States also have
discretion to cover additional low-income individuals in each of these categories (“optional groups’) and receive federal matching payments. Optional eligibility
categories include children and parents, persons with disabilities and the elderly above mandatory coverage limits; persons residing in nursing facilities; and the
KP medically needy. Source: Kaiser Family Foundation, 2005 (@)E) www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 319
Restructure Medicare & Medicaid: Policy Option # 4 —
Reducing Optional Services + Beneficiary Groups! Could Save Up to 60% of Annual Medicaid Spending
Medicaid Expenditures by Eligibility Group and Type of Service, 2001
Mandatory Mandatory Services’ for Services for Optional Mandatory Groups Groups Eliminating ; optional groups Federal-required mandatory services could save bat ~42% of total groups = ~40% Medicaid Optional =~ total spending di Services* for eet reultel Optional Groups Optional Services for Mandatory Groups
Eliminating optional
services could save ~30% of total Medicaid spending
Note: 1) Medicaid is a jointly financed federal and state program that provides health and long-term care services to 55 million low-income Americans. As a
condition of participating in Medicaid, states are required to cover certain “mandatory” populations and to provide a specified set of benefits. States also have
discretion to cover additional low-income individuals in each of these categories (“optional groups”) and receive federal matching payments. Optional eligibility
categories include children and parents, persons with disabilities and the elderly above mandatory coverage limits; persons residing in nursing facilities; and the
KP medically needy. Source: Kaiser Family Foundation, 2005 (@E) www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 320
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