Now is the Time to Get Serious About Benefits Innovation

A March 26 story in the Wall Street Journal highlighted one of the most significant gaps in the administration of the nation’s largest healthcare program. According to the WSJ, billions of dollars are wasted each year because multiple states are paying into Medicaid for the same beneficiary. This is largely because the individual state systems are completely disconnected from one another; one state’s system literally can’t and doesn’t speak to another. Hence, when beneficiary status changes occur—be they geographic or other—there is no system to ensure that information is shared. To be clear, this is not a new issue. The Government Accountability Office has highlighted the problem in numerous reports.

But the WSJ article also highlights another key issue: at a time when reducing the costs, improving beneficiary service, and enhancing program integrity are all top of mind, we have a unique opportunity in time to take a holistic look at Medicaid and collectively define reforms that provide the greatest chance of meeting those three tests. For example, CAMI believes that the GAO reports (and the new WSJ article) provide irrefutable rationale for creating a system of integrated Medicaid data—a national accuracy clearinghouse, much like the one mandated in 2018 for SNAP (but has, unfortunately, been far too slow to roll out and may face growing barriers ahead). CAMI has also long advocated giving states the flexibility to administer their programs as they see fit, including utilizing technology and private sector partners, provided they adhere to a set of immutable guardrails. Meanwhile, an unusual bipartisan coalition of Senators, including Sens. Bill Cassidy, Ron Wyden, Rick Scott and others, is advocating for a review of asset limits for Medicaid recipients, since it has been more than 35 years since the limits were adjusted. Sen. John Barrasso is proposing that all Medicaid recipients be subject to asset verification tests, and battles over administrative funding are already being joined.

All of this argues for a serious, coordinated, and bipartisan effort to assess each of these, and other, proposals, and to determine what combination of initiatives will best enable us to better control costs, ensure accuracy, and enable the efficient and timely delivery of benefits to constituents. There is no shortage of ideas. What we need now is leadership to bring them all, and the relevant stakeholders, together.