State Medicaid Programs – New York, Utah

New York’s model for Medicaid managed care, By Christopher Flavelle, August 23, 2012, Businessweek: “In February officials from the New York State Department of Health summoned senior executives from WellCare Health Plans (WCG) to a private meeting in Albany. Attendance was not optional. For the third straight year, WellCare, which covers 75,000 New York State Medicaid beneficiaries, had just received low marks for the quality of care it was delivering, a scorecard that includes doctor visits for children, diabetes treatment, and cancer screenings. In most large states, that would be unremarkable: Many Medicaid managed-care plans, especially those run by for-profit insurers, report below-average access to medical services with few consequences, according to a study conducted by Bloomberg Government…”
Utah Medicaid stops paying for hospital errors but data spotty, By Kirsten Stewart, August 23, 2012, Salt Lake Tribune: “Utah’s Medicaid program no longer pays hospitals to treat illnesses and injuries caused by poor care for patients, such as infections, on-site falls and surgeries on the wrong body part. Hospitals have had to report these ‘provider-preventable conditions’ to the Utah Department of Health since July 2011, a requirement of federal health reform. They’ve disclosed 17 to date, most of them infections. But precisely how much taxpayer money was saved isn’t known…”