Medicaid Beneficiary Fluctuations are Leading to More Costs

According to an article in a 2005 edition of the journal Cancer, patients with breast and cervical cancer who were enrolled in Medicaid for longer periods of time had less severe cancers than those enrolled for shorter periods, perhaps because their disease was caught earlier in its progression.

Interruptions in Medicaid coverage are also associated with the greater use of expensive, inpatient psychiatric services and higher psychiatric costs, while those with more continuous coverage required shorter and less expensive behavioral health treatment.

LA Care's Bachelor said that not having continuity policies defeat the federal government's goal to keep track of people's chronic conditions. "When they're churning, it takes them time to get reconnected when they do come back to the system, and by then, they may even get a different (patient) number, don't live at the same address, and have a different phone number."

"For a commercial health plan, it costs money to build a disease management plan. And you might have some commercial plans saying it's not worth creating these plans because, they realize, [because of churning] 'we won't have a large enough cohort two years from now.'"

In addition to establishing a Medicaid Continuous Quality Act that would require states to provide 12-month continuous eligibility to child, adult, aged, blind, and disabled enrollees, the report recommends these other actions to improve Medicaid care:

• Establish a performance-based bonus payment system for states that enhance retention


• Provide matching funds for electronic data sharing


• Expand the scope of Medicaid Quality reporting comparisons