Medicaid Fraud: Following the Money | TWE 183

​How Medicaid’s incentives affect taxpayers, states, doctors, and patients.

Nearly $2 billion recovered. More than 1,100 convictions. And $37.4 billion in estimated improper Medicaid payments. 

Those numbers matter, but they're not the whole story.

The bigger question I put on the table in this week's episode is: What incentives have we built into Medicaid itself?

Washington and the states share Medicaid costs. That can make another dollar of spending look relatively inexpensive from an individual state's budget, even though taxpayers ultimately finance the federal share too.

Then add provider taxes, intergovernmental financing, insurers, reimbursement rules, and layers of administration. The system can become better at moving money than empowering patients.

That's why I think reform needs to go beyond prosecuting fraud.

States should have more flexibility, paired with greater fiscal responsibility. Federal financing should reward better use of resources rather than simply encouraging additional qualifying spending. And reform shouldn't stop at the state capitol.
Put patients and doctors back at the center.

Patient-controlled healthcare dollars, direct primary care, useful price transparency, and greater provider competition can help reconnect the people receiving care with the people providing it.

Medicaid should remain a safety net for vulnerable Americans. That's precisely why its resources should be protected.

Watch or listen to the full episode and find more of my work at VanceGinn.substack.com.