title: Toward real medicaid reform.
abstract: In this paper we argue that there is a real need for Medicaid reform primarily because of the large differences among states in coverage and benefits and because of the program's high and rising costs. We describe and develop several options for Medicaid reform that would expand coverage, provide fiscal relief to states, shift responsibility for some or all of the care of dual eligibles to the federal government, and eliminate or restructure disproportionate-share hospital (DSH) payments. We conclude with a discussion on a number of other issues, particularly Medicaid cost containment and the federal matching payment structure.
authors.affiliation: Health Policy Center, Urban Institute, Washington, DC, USA. jholahan@ui.urban.org
authors.forename: John
authors.initials: J
authors.lastname: Holahan
authors.forename: Alan
authors.initials: A
authors.lastname: Weil
mesh_terms: D003363:Cost Control; D003362:Cost-Benefit Analysis; D018166:Health Care Reform / Q000458:organization & administration*; D006801:Humans; D008484:Medicaid / Q000458:organization & administration*; D020380:Needs Assessment; D011050:Policy Making; D020444:Reimbursement, Disproportionate Share; D013221:State Health Plans / Q000458:organization & administration; D014481:United States