Reform Medicaid First
Laying the Foundation for National Health Care Reform

  • Title:

    Reform Medicaid First
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    Paperback
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    15.00
  • Paperback ISBN:

    978-0-8447-4316-5
  • Paperback Dimensions:

    5.5'' x 8.5''
  • 62 Paperback pages
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As Congress contemplates major revisions to America's health care system, two leading health economists warn that significant differences among state Medicaid programs will hinder national health care reform. Thomas W. Grannemann and Mark V. Pauly argue that Medicaid will need to be reformed as an early step in any serious health care reform effort. While states such as Mississippi and Nevada spend as little as $5,000 per poor person annually, New York and Alaska annually spend more than $15,000 per Medicaid patient. Large differences remain even after correcting for cost-of-living and medical-price differences. This imbalance among states creates an uneven and unstable foundation for any national program to address the needs of uninsured Americans.

The authors offer principles for reform designed to encourage equity, efficiency, and accountability in all publicly funded health care programs. They suggest changes in provider payment methods and federal/state financing designed to promote interstate equity, equality of payment across settings, claims-based accountability, provider network control, and value-based cost containment. Such reform will require upfront changes in Medicaid to improve access to high-value health care for low-income persons (particularly those in low-Medicaid-benefit states) and to help slow the rate of growth in medical costs. These changes will level the playing field for state programs and provide a crucial foundation for further national reform.

Thomas W. Grannemann is a health economist and an associate regional administrator for the Centers for Medicare and Medicaid Services in Boston.

Mark V. Pauly is a professor in the Health Care Management Department at the University of Pennsylvania's Wharton School.

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About the Author

 

Mark V.
Pauly

  • Mark V. Pauly is the Bendheim Professor in the Department of Health Care Management;  professor of health care management, insurance and risk management, and business and public policy at the Wharton School; codirector of the Roy and Diana Vagelos Life Sciences and Management Program; and professor of economics in the School of Arts and Sciences at the University of Pennsylvania. A former commissioner on the Physician Payment Review Commission, Mr. Pauly has served on the advisory committee to the Agency for Health Care Research and Quality and on the Medicare Technical Advisory Panel. He currently serves on the National Advisory Council for the National Institutes of Health National Center for Research Resources, the National Academy of Sciences' Committee to Study the Veterinary Workforce, and its Committee on the Biomedical Workforce. He has been a consultant to the Congressional Budget Office, the Office of the Secretary of the US Department of Health and Human Services (which supported some of his work on individual health insurance), and health trade associations. Mr. Pauly is a coeditor-in-chief of the International Journal of Health Care Finance and Economics and an associate editor of the Journal of Risk and Uncertainty.  


  • Phone: 2158986861
    Email: pauly@wharton.upenn.edu

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