Changes
in Medicaid and the Impact on SMHA's:
Issues in Medicaid Policy and System Transformation:
Recommendations From the President’s Commission
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The
article, "Issues in Medicaid Policy and System Transformation:
Recommendations From the President's Commission," by
Stephen Day, M.S.W. states that "efforts to ensure that
people with
disabilities participate fully in
their communities have raised awareness of current Medicaid
policies that impede provision of best-practice mental health
services. The author summarizes issues that were examined by
the Medicaid Subcommittee of the President’s New Freedom
Commission and its recommendations in four areas: access, service
delivery, service coordination, and quality.
Because of
Medicaid’s substantial role as a
payer for mental health services, more creative and flexible
program policies can promote system transformation. Current
eligibility rules and time-consuming procedures can inhibit
timely access to Medicaid coverage for
people with mental illness. Medicaid benefit plans may create
financial incentives for maintaining more traditional but less
effective models of care.
Some policies
impede states’ ability to coordinate Medicaid
funding with other sources of funding to create systems of
community-based care. Medicaid does not provide specific requirements
to ensure that individuals with depression are identified and
offered informed choices about treatment through primary or
specialty care providers. Action steps to address these and
other issues include use of presumptive eligibility and parity,
retention of coverage as enrollees enter the workplace, guidance
to states on evidence-based practices and service coordination
with other agencies, more flexible financing mechanisms,
improved data
collection and reporting, and enhanced integration of primary
and mental health care." (Day, S. "Issues
in Medicaid Policy and System Transformation: Recommendations
From the
President's Commission," Psychiatric Services 57:1713–1718,
2006).
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