Differences in costs of Medicaid spending by state. Some are obvious, largely populated states will spend more. but when you compare them in the more compareable population centers there are vast differences. Why? Again, it is multifactorial.
http://www.statehealthfacts.org/comp...?ind=177&cat=4
Vast differences among the states programs accounts for many of cost differences.
http://www.kff.org/medicaid/upload/T...ate-Survey.pdf
An example of one states experiences with costs of Medicaid that also shows where the waste goes and the differences between the states:
Quote:
James Mehmet, former chief state investigator of Medicaid fraud and abuse in New York City, told The New York Times on July 18 that fraud equals about 10 percent of total Medicaid dollars spent each year. In addition, the use of medically unnecessary services and procedures that probably doesn't rise to the level of criminality siphons off an additional 20 to 30 percent, he said.
"So we're talking about 40 percent of all claims [that] are questionable," according to Mehmet. All told, nearly $18 billion of the New York Medicaid budget is spent on fraudulent or medically unnecessary services and procedures, Mehmet said.
Doctors, drug makers, hospitals, and their unions have all fought attempts to provide tighter oversight of Medicaid spending. "All of the emphasis of the coalition in New York has been on expanding the size of the program, and that's where the payoff is for politicians," said Stephen Malanga, a senior fellow at the Manhattan Institute.
Any attempts to rein in spending on unnecessary, wasteful medical services are fought bitterly by those profiting from such waste. As a result, the state has failed to experiment with reforms that other states have used successfully. "There's been little emphasis on reform or eliminating waste, so that even as the program has grown to become the largest in the nation, the state office that investigates fraud and waste in Medicaid has been shrinking," Malanga said.
Runaway Costs
New York's Medicaid program is the largest and most costly in the nation. Although the state accounts for less than 7 percent of the U.S. population, nearly 14 percent ($45 billion) of Medicaid funds nationwide will be spent there in 2005 on more than 4 million enrollees, according to the National Governors Association.
Per capita, New York Medicaid spending is 130 percent more than the national average, according to the Public Policy Institute of New York State. The state spends $10,788 per Medicaid enrollee--more than $43,000 to insure a family of four. New York spends more on almost every service category than comparable states: hospitalization, long-term care, and in-home and personal care.
New York spends about as much on Medicaid as do California and Florida combined, despite having only about a third of their combined population. The federal government pays 50 percent of New York's Medicaid costs, and the state shifts nearly one-third of its remaining costs to the counties.
"New York spends far too much on Medicaid. We can cut costs sharply and still improve quality dramatically," said Robert Ward, director of research for the Public Policy Institute of New York State. According to The New York Times, Medicaid has become "an economic engine that fuels one of the state's biggest industries."
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http://healthcare.ncpa.org/commentar...-york-medicaid
The one thing that the article does not show is that Medicaid pays the least amount of all insurance programs and I think it encourages providers and organizations to attempt to recoup costs by ordering many more tests than they would on a cash paying patient or one with insurance.