Sebelius offers alternatives to Medicaid waivers

Noting that 1 percent of Medicaid beneficiaries account for 25 percent of the program’s costs, Sebelius said initiatives that integrate and coordinate care have helped states improve care quality and lower costs.

Sebelius also said that the department is working to help Medicaid programs purchase drugs more efficiently and improve program integrity. The department also recently created a new office to better manage “dual eligibles,” individuals who qualify for Medicare and Medicaid and tend to have greater healthcare needs.

Thirty-three governors and governors-elect, seeking to reduce their Medicaid obligation in the face of mounting deficits, last month asked Sebelius to waive a healthcare reform provision that requires states to maintain their Medicaid eligibility requirements until new insurance exchanges open in 2014. Under the law, states that toughen eligibility requirements could lose federal funding for Medicaid.

Brewer last week asked Sebelius for permission to drop 280,000 individuals from the state’s Medicaid rolls. Sebelius noted in her Thursday letter that states facing a budget deficit have the flexibility to reduce eligibility for non-disabled, non-pregnant adults with incomes above 133 percent of the federal poverty line.

HHS said it would host “virtual” meetings with state Medicaid directors and health policy advisers to share information about cost-saving initiatives the department supports.