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New York Medicaid

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Source: Kaiser Family Foundation, StateHealthFacts.org. Medicaid Spending ... transportation, abortions, prosthetic devices, eyeglasses and home and community ... – PowerPoint PPT presentation

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Title: New York Medicaid


1
New York Medicaid
  • Tarren Bragdon
  • Health Policy Analyst
  • Empire Center for New York State Policy
  • tbragdon_at_EmpireCenter.org

2
Medicaid Eligibility
6th highest
8th highest
8th highest
Source Kaiser Family Foundation,
StateHealthFacts.org
3
Medicaid Spending Per Enrollee
112 higher
110 higher
90 higher
90 higher
44 higher
Source Centers for Medicare and Medicaid
Services, 2003 figures
4
Medicaid Utilization Spending
  • Definitions
  • Clinic services These include preventive,
    diagnostic, therapeutic, rehabilitative, or
    palliative items or services that are provided to
    outpatients and by a facility that is not part of
    a hospital but is organized and operated to
    provide medical care to outpatients including
    services furnished outside the clinic by clinic
    personnel to individuals without a fixed home or
    mailing address.
  • Home health - These are services provided at the
    patient's home, in compliance with a physician's
    written plan of care that is reviewed every 62
    days, including.
  • Nursing services that is provided on a part-time
    or intermittent basis by a home health agency
  • Home health aide services provided by a home
    health agency and
  • Medical supplies, equipment, and appliances
    suitable for use in the home.
  • The following optional therapy services are
    optional physical therapy, occupational therapy,
    or speech pathology and audiology services
    provided by a home health agency or by a licensed
    rehabilitation facility.

Source Centers for Medicare and Medicaid
Services, 2003 figures
5
Medicaid Utilization Spending
  • Definitions
  • ICF/MR (institutions for those with disabilities)
    - These are services provided in an institution
    for mentally retarded persons or persons with
    related conditions. The primary purpose of the
    institution is to provide health or
    rehabilitative services to such individuals.
  • Personal care/support - These are services
    furnished to an individual who is not an
    inpatient or resident of a hospital, nursing
    facility, intermediate care facility for the
    mentally retarded, or institution for mental
    disease that are
  • Authorized for the individual by a physician in
    accordance with a plan of treatment or (at the
    option of the State) otherwise authorized for the
    individual in accordance with a service plan
    approved by the State and
  • Provided by an individual who is qualified to
    provide such services and who is not a member of
    the individuals family.
  • Other services These include transportation,
    abortions, prosthetic devices, eyeglasses and
    home and community-based services for those with
    mental retardation and/or developmental
    disabilities (the majority of spending in NY
    likely falls in this last category with
    transportation being next)

Source Centers for Medicare and Medicaid
Services, 2003 figures
6
Medicaid Utilization Spending
Source Centers for Medicare and Medicaid
Services, 2003 figures
7
Medicaid Utilization Spending
Source Centers for Medicare and Medicaid
Services, FY2003 figures
Total savings does not include Managed Care
Drugs
8
Medicaid the Uninsured (those under 65 years
old)
Source US Census Bureau
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