Medicaid Preventive Services
Providing Medicaid recipients with access to preventive services addressing leading causes of poor health can reduce the incidence and severity of diseases and chronic conditions for a population with some of the highest health care expenditures.
*Milestone details:
*Full name: Evaluate the option of providing additional preventive services and vaccines in Medicaid without cost sharing in order to quality for increased FMAP.
*Relevance to the ACA:
States have the opportunity to offer additional preventive services to Medicaid beneficiaries and receive a higher federal match for these services.
§4106 – Effective Jan 1, 2013, specific additional preventive services will qualify for a Medicaid FMAP increase of 1%.
The services that are eligible for increased FMAP include:
1. Any clinical preventive services that are assigned a grade of A or B by the United States Preventive Services Task Force;
2. Approved adult vaccine recommended by the Advisory Committee on Immunization Practices; and
3. Any medical or remedial services (provided in a facility, a home, or other setting) recommended by a physician or other licensed practitioner for the maximum reduction of physical or mental disability and restoration of an individual to the best possible functional level.
less
comment, ask a question or post a document
Login or Register to participate in this discussion or post a document
District of Columbia
Blumenthal and coauthors report on three state Medicaid programs that provided incentives to beneficiaries to engage in healthy behavior and find that the programs produced mixed results. Some programs had few participants while others came closer to meeting their goals. The authors recommend the programs be better designed so that they are understood by enrollees and have incentives to attract participation. They also recommend evaluation of the programs to establish their effectiveness.
District of Columbia
In the Striving to Quit program, the Wisconsin Department of Health Services’ Tobacco Quit Line will connect adults who have Badger Care (Medicaid) coverage, with evidence-based tobacco cessation treatment services at primary care clinics. Wisconsin, along with Minnesota, New York, Nevada, New Hampshire, Montana, Hawaii, Texas, California, and Connecticut were selected to participate in the Medicaid Incentives for Prevention of Chronic Diseases Program. This CMS program is designed to evaluate the effectiveness of a program providing financial and non-financial incentives to Medicaid beneficiaries of all ages who participate in prevention programs and demonstrate changes in health risk and outcomes. Visit this site to learn about other state activities.