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Abstract:
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When state Medicaid agencies propose new programs for cost-savings or disease managements, they often have to demonstrate to the Centers for Medicare and Medicaid Services (CMS) that the programs do not increase costs (budget neutrality). This issue can be quite problematic because various programs such as preferred drug lists and others are implemented concurrently. In this presentation, we focus on one particular program in the Alabama State Medicaid Agency called Patient 1st, which currently has 420,000 Alabamians enrolled. Methods for estimating cost savings and savings sharing for participating physicians are presented. In addition to costs savings issues, we also present our attempts to characterize those eligibles who have not yet signed up for the mandatory program.
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