The recent unveiling on an “unprecedented” state proposal to convert its Medicaid program into a block grant system has a Tennessee provider advocate on high alert as it evaluates the plan’s possible impact.
State officials released details of their first-of-its-kind Medicaid block grant proposal on Tuesday. They plan to submit a final draft to federal authorities in November, the Associated Press reported.
Any alternative to Medicaid must ensure sustainability for the state’s elderly population and preserve their choice to have nursing or assisted living services when necessary, said Jesse Samples, executive director of the Tennessee Health Care Association in a statement to McKnight’s.
Nursing home operators have traditionally opposed moving Medicaid into a block grant system.
Samples said his organization is still evaluating the proposal but a number of items it has previously addressed “could lead to positive changes, including a per capita spend, wage index adjustment, and protection of dual eligibles.”
“However, the waiver, by its very nature, requests an unprecedented exception from existing federal regulations, some of which are designed to protect both providers and beneficiaries alike from managed care practices that are detrimental to patient care,” Samples said.
“We certainly believe that flexibility is needed in some areas, but it must be carefully evaluated in sufficient detail to show how providers and patients will continue to be adequately protected within the Medicaid program.”
Federal Medicaid funding currently pays states a percentage of healthcare costs for eligible beneficiaries. Under the proposal, the state would receive its Medicaid funds in a lump sum and that amount would be calculated based on projected costs for providing care to the TennCare member population.
The block grant amount for Tennessee was estimated to be $7.9 billion. If finalized, it would make Tennessee the first state in the nation to receive its Medicaid funding this way.
State officials said they want to be the “leader in reforming the financial incentives in Medicaid to show that it is not only possible but desirable” to use block grants. They said it would “relentlessly” drive quality care, add program efficiency and sustainability in how it serves vulnerable individuals.