Dec 2, 2019

New Research on Delivery System Innovation and Medicaid Expansion

Shannon Dailey Staff writer

Delivery System Innovation Is the Key to Better Healthcare

Robert Graboyes | Testimony

Mercatus scholar Robert Graboyes recently testified before the Rural and Underserved Communities Health Task Force to discuss possible solutions and policy prescriptions to end the zero-sum game of healthcare policy. He suggests less emphasis on payment models and more focus on the delivery of care, which is more likely to increase quality of healthcare. 

He suggests a larger increase of resources by removing barriers and restrictions in healthcare across the country. The people most impacted by low quality healthcare services are those living in rural or underserved areas, and a fancy new insurance card won’t do half as much for those people as delivery system reforms would, and Graboyes suggests a solution to this particular issue would be removing barriers to innovation in telemedicine. 

Other recommended policy prescriptions include removing obstacles to charity care, easing restrictions on medical drones, and encouraging innovative business models. Graboyes also strongly suggests opening up a market for a wider diversity of providers by easing restrictions on nonphysician providers, lessening certificate-of-need requirements, welcoming international medical graduates, and accommodating military spouses by removing occupational licensing barriers. 

The ACA's Medicaid Expansion

Brian Blase, Aaron Yelowitz | Research Paper 

Brian Blase and Aaron Yelowitz outlined four key recommendations in their most recent research paper on the ACA’s Medicaid Expansion:

First, Congress should reform Medicaid financing so that states have better incentives to obtain value from pro­gram expenditures, by making fixed payments to states rather than open-ended reimbursements and by equalizing the reimbursement rate between traditional Medicaid populations and the expansion group. Secondly, Blase and Yelowitz propose that the Center for Medicare and Medicaid Services should recover costs that have been improperly claimed. Additionally, they recommend the CMS target states and regions with particularly egregious abuses of the system for immediate eli­gibility redeterminations. Finally, they state that the Congressional Budget Office should evaluate why initial cost estimates were so inaccurate and work to more accurately model the Medicaid expansion going forward.

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