More news from Lil Rhodey

By Jim Stergios
December 23rd, 2008

As Massachusetts seems bent on assuming Rhode Island’s well-earned mantle for corruption, Rhodey seems intent on catching up to Massachusetts. Yesterday, we highlighted education efforts by mayors across Rhode Island. Kudos to the RI mayors.

What about the “global waiver” sought and obtained by Governor Don Carcieri –and announced yesterday? All this is from the press release. The proof will be in the implementation…

The waiver agreement (see here and here) between the federal Centers for Medicare and Medicaid Services and RI is aimed at improving services and expanding consumer choices, according to the Governor, who noted that

This agreement will put us on a sustainable path for growth in Medicaid while also maintaining services for those most in need. I applaud the cooperation and hard work put forth by the federal government and our staff at DHS for making this reform possible.

US Department of health and Human Services Secretary Mike Leavitt:

This demonstration will allow Rhode Island increased flexibility to adjust its Medicaid program to better serve the health care needs of the state’s beneficiaries. In particular, this demonstration advances the Bush administration’s efforts to provide more long-term care services in home and community-based settings.

The Rhode Island waiver means the state will get federal funding certainty and flexibility to redesign the state’s Medicaid program. The goals? Cost-effective services by

bypass[ing] many of the cumbersome and costly federal regulations and offer services specifically focused to meet Rhode Island’s needs. At the same time, it will help to allow DHS to meet its budget targets. The current state budget counts on millions in savings from Medicaid reform efforts to balance the Department’s finances.

Importantly

The major tenets of Medicaid Reform include reforming the way long term care is provided and implementing a prevention-based care system across all Medicaid beneficiaries.

Reforming long-term care to emphasize home and community-based settings such as assisted living and in-home care, where possible, will enable beneficiaries to maintain a family or community-based lifestyle. Under the Global Waiver Compact, decisions on the type of service and the setting for those services will be determined in consultation with the beneficiary and the family, as well as on the level of care needed.

One of the central goals of the Waiver is to reorient the Medicaid program to reward responsible personal choices, including prevention and wellness. An individually-based system provides comprehensive primary care that facilitates partnerships between beneficiaries, physicians, other healthcare professionals and community providers and, when appropriate, the beneficiary’s family. Further, the Waiver will implement care management instruments across populations, increasing the opportunity for more efficient monitoring of access and quality, and greater use and efficacy of performance-based payment incentives.