Medicaid waiver reveals frictions between providers, hospitals

A federal waiver and additional funding Texas officials procured for its Medicaid program could be indicative of challenges the rest of the nation faces in trying to reform care for the poor, The Texas Tribune reported.

The Texas waiver pivots on the collaboration of hospitals and doctors to reduce the hospitalization rates of Medicaid enrollees and get them into medical homes to receive proper preventative care. As much as $11.4 billion could be provided by the Centers for Medicare & Medicaid Services for the waiver, according to the Austin American-Statesman. However, the proposed programs are exposing frictions between the various provider communities in the Lone Star State.

"We just had a much more ambitious idea of what this could accomplish," said Rick Snyder, M.D.,  president of the Dallas County Medical Society, of a failed initiative to expand an existing medical home program. The program's expansion was predicated on how much financial risk both the physicians and hospitals were willing to take, and that ultimately left the program underfunded, according to the Tribune.

Meanwhile, in Maine, which also is attempting a waiver that would shift part of its Medicaid program to an outcome-based system, the layers of bureaucracy required to approve such a project is likely to negate any potential savings in the short run, reported the Bangor Daily News.

For more:
- read theTexas Tribune article
- here's the American-Statesman article
- read the Bangor Daily News article