14. The Long Term Care Medicaid Reimbursement Problem

Abstract

A growing public concern about the high cost of Medicaid reimbursement for Long Term Care (LTC) has created the need for careful analysis of the causes & consequences of past public policies and to develop strategies that provide solutions to identified problems. Guiding the team through the assigned simulation, that reflects a serious public concern, were our stated political values serving to shape our policy proposals. Using a systems approach, we analyzed current public policy and explored alternatives. We considered the forces that operate in the environment producing demands on the political system, pressing for allocation of resources toward desired objectives. An integral part of the medical inflation picture, Medicaid reimbursement costs reflect the system's failure to create a cost-effective balance between supply and demand, government and the private sector, quality and price, provider and consumer, flexibility and control.