Medicaid Capitation Payments by State

Congress has repeatedly proposed changing Medicaid from an entitlement to a block grant. Each state would receive a fixed amount instead of a Federal payment influenced by state decisions on eligibility, coverage, and pricing. This paper uses existing data series to simulate redistributing the annua...

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Main Author:	David C. Hsia JD, MD, MPH
Format:	Article
Language:	English
Published:	SAGE Publishing 2019-12-01
Series:	Inquiry: The Journal of Health Care Organization, Provision, and Financing
Online Access:	https://doi.org/10.1177/0046958019892882

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spelling	doaj-aa9907a0a0fa457b8d32ec80e2d4a5622020-11-25T03:03:34ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95801945-72432019-12-015610.1177/0046958019892882Medicaid Capitation Payments by StateDavid C. Hsia JD, MD, MPH0MITRE Corporation, McLean, VA, USACongress has repeatedly proposed changing Medicaid from an entitlement to a block grant. Each state would receive a fixed amount instead of a Federal payment influenced by state decisions on eligibility, coverage, and pricing. This paper uses existing data series to simulate redistributing the annual $353 billion Federal payment among Medicaid’s 56 state (and territorial) programs. Capitation by general population would shift $52 billion, mainly from large Northeastern and West Coast states to large Southern and Mountain states. Capitation by population below the Federal Poverty Line (FPL) would shift $60 billion in a similar pattern. Policymakers should understand likely state-to-state effects when considering Medicaid legislation. States could then prepare for possible changes in their Federal payment for Medicaid.https://doi.org/10.1177/0046958019892882
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	David C. Hsia JD, MD, MPH
spellingShingle	David C. Hsia JD, MD, MPH Medicaid Capitation Payments by State Inquiry: The Journal of Health Care Organization, Provision, and Financing
author_facet	David C. Hsia JD, MD, MPH
author_sort	David C. Hsia JD, MD, MPH
title	Medicaid Capitation Payments by State
title_short	Medicaid Capitation Payments by State
title_full	Medicaid Capitation Payments by State
title_fullStr	Medicaid Capitation Payments by State
title_full_unstemmed	Medicaid Capitation Payments by State
title_sort	medicaid capitation payments by state
publisher	SAGE Publishing
series	Inquiry: The Journal of Health Care Organization, Provision, and Financing
issn	0046-9580 1945-7243
publishDate	2019-12-01
description	Congress has repeatedly proposed changing Medicaid from an entitlement to a block grant. Each state would receive a fixed amount instead of a Federal payment influenced by state decisions on eligibility, coverage, and pricing. This paper uses existing data series to simulate redistributing the annual $353 billion Federal payment among Medicaid’s 56 state (and territorial) programs. Capitation by general population would shift $52 billion, mainly from large Northeastern and West Coast states to large Southern and Mountain states. Capitation by population below the Federal Poverty Line (FPL) would shift $60 billion in a similar pattern. Policymakers should understand likely state-to-state effects when considering Medicaid legislation. States could then prepare for possible changes in their Federal payment for Medicaid.
url	https://doi.org/10.1177/0046958019892882
work_keys_str_mv	AT davidchsiajdmdmph medicaidcapitationpaymentsbystate
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Medicaid Capitation Payments by State

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