There are 85.2 people that rely on the solutions that Medicaid provides. At least 2 million of that group is represented by seniors and those with disabilities alone. 1 in every 5 U.S. citizens is covered by Medicaid and the program itself specifically caters to those with lower income or limited resources for income.
It is jointly funded by the federal and state governments, and each state has its own Medicaid program with its own eligibility requirements and benefits that are operated within federal guidelines. This public health insurance program helps to solve a variety of problems from increasing access to healthcare for those where access is limited or nonexistent, expanding healthcare coverage, and reducing out-of-pocket costs and also has the potential to help increase care quality.
All of these features are only some of the reasons why understanding Medicaid and keeping up with its trends is important. We’re going to explore Medicaid, expected changes, and current trends so keep reading if you’re a senior living in Florida that could benefit.
Seniors, Did You Know That Millions of People Could Be Removed From Medicaid This Year?
As of 2023, there are several changes to the Medicaid program that individuals and families should be aware of. If you’re a senior and you’re enrolled in Medicaid, you may have heard that millions of enrollees could get kicked off of the program. These enrollment reductions started to take place on March 31, 2023, and are expected to last until July 31, 2024. This may come as a slight shock for seniors and for other eligible citizens considering that on a federal level, it was prohibited for states to kick people off of Medicaid for a certain time, mainly during the COVID-19 pandemic.
Currently, the game of catch-up is being played throughout the U.S. Throughout 2023, states are expected to start rechecking the eligibility of those on Medicaid. This is something that could have changed since the start of COVID-19 and now that the economy is trying to return to normalization, the federal government wants accurate enrollment numbers and status among program beneficiaries.
A Look at the Requirements and Trends
Starting in 2023, states will be able to apply for a waiver from the federal government to implement work requirements for Medicaid beneficiaries. This is another trend that is hitting the books again this year and what this means is that certain individuals who are eligible for Medicaid will be required to work, volunteer, or participate in job training programs for a certain number of hours each week in order to maintain their Medicaid coverage. The goal of this policy is to encourage individuals to become self-sufficient and reduce dependence on government assistance.
However, critics of work requirements argue that they may actually harm low-income individuals and families by making it more difficult for them to access healthcare. For example, some individuals may struggle to meet the work requirements due to a lack of job opportunities, disabilities, or care-giving responsibilities, which could result in them losing their Medicaid coverage. This is often a concern for seniors considering that there are more obstacles related to doing certain types of work that are either physically or mentally limiting.
Also, starting in 2023, states will be able to offer Medicaid beneficiaries a wider range of benefits through value-based care arrangements. Value-based care is a healthcare delivery model that focuses on achieving better health outcomes for patients while reducing costs. Under this model, healthcare providers are paid based on the quality of care they provide, rather than the number of services they deliver. This trend in particular is taking the healthcare industry by storm and is leading healthcare in a positive direction which will be beneficial for seniors and other populations.
By implementing value-based care arrangements, states can encourage healthcare providers to prioritize preventive care, chronic disease management, and other services that improve health outcomes while reducing the need for costly hospitalizations and emergency room visits. This is something that could significantly change the lives and wellness status of seniors for the better.
Third, as of 2023, states will be required to implement electronic visit verification (EVV) for certain Medicaid-funded home health services and this requirement went into effect at the start of the year. EVV is a system that electronically verifies the date, time, and location of home health services provided to Medicaid beneficiaries. The goal of EVV is to prevent fraud and abuse in the Medicaid program by ensuring that services are actually being provided to beneficiaries as claimed. Keep in mind that seniors are often more susceptible to healthcare fraud and abuse so, this verification system will be a positive trend as we see Medicaid evolve this year.
However, some critics of EVV argue that it could create additional administrative burdens for home health providers and make it more difficult for beneficiaries to receive timely and necessary care. This is, however, something that will take more streamlined strategy planning and accommodation but it can be done.
What Else Seniors Should Know
Seniors should also know that states will be required to use uniform assessment tools to determine the needs of Medicaid beneficiaries who require long-term services and support (LTSS). This requirement is part of the Community-Based Services State Plan Option, which allows states to offer LTSS to Medicaid beneficiaries in their homes and communities rather than in institutions.
By using uniform assessment tools, states can ensure that Medicaid beneficiaries receive the appropriate level of care and services based on their individual needs, rather than relying on a one-size-fits-all approach. This can lead to better health outcomes for beneficiaries and lower costs for the Medicaid program. If you haven’t noticed, this also compliments the efforts of the U.S. healthcare system in moving further toward a value-based care model.
Additionally, states will be required to implement a new Medicaid Information Technology Architecture (MITA) framework. The MITA framework is designed to improve the efficiency and effectiveness of state Medicaid programs by standardizing the technology infrastructure used to support them. While this may seem like a mouthful, what it does will help to optimize the way Medicaid is run. By adopting the MITA framework, states can reduce administrative costs, streamline Medicaid program management, and improve the quality of care provided to Medicaid beneficiaries.
Seniors and Understanding the Changes in Medicaid
The Medicaid program is undergoing several changes as of 2023 that are aimed at improving the efficiency and effectiveness of the program, while also ensuring that Medicaid beneficiaries receive high-quality care that meets their individual needs. While some of these changes may create challenges for individuals and families, especially seniors who rely on Medicaid for their healthcare coverage, they also have the potential to improve health outcomes and reduce costs in the long run.
It will be important for states to carefully implement these changes and monitor their impact on Medicaid beneficiaries and the healthcare system as a whole. It will be just as important for seniors to stay up-to-date with these changes and trends to determine how they will directly affect them.
