Medicaid Cutbacks

Decision making is never easy for managers of any healthcare clinic. For effective decision making, a manager must be able to determine the outcome of each option and then determine the best option for their organization (http://www.freedictionary.com). Medicaid is a program that serves the poor and disabled and has more than fifty million beneficiaries and more than $300 billion a year federal and state program. Currently, Medicaid spending has increased up to 63% in the last five years and making the program the country's largest health insurance program and remains the second largest items in most state budgets (Clark, 2012). According to the Congressional budget office, Medicaid will continue to increase on average 8.5% percent each year (Clark, 2012). Medicaid implemented by both federal and state agencies. The federal government's job is to match state spending under Medicaid but this solely depends on the state. Due to the economic pressures, many states funds have been depleted therefore; cutbacks on certain clinical services are having to because there is not enough money to fund these services. This paper will discuss the clinical services that will be cut in order for the clinic to continue to meet the needs of the patients.

Due to the economic recession in 2008, the majority of states across our nation are cutting Medicaid spending. These cuts will have an impact on individuals who depend on Medicaid for critical and long term services. With decreased Medicaid budgets means that hundreds of individuals with disabilities will remain on waiting lists across the country (http://www.ucp.org). Nearly fifty Americans will continue to be without health insurance and those who have insurance will continue to pay a higher co-payment for doctor visits and higher deductibles for out of pocket expenses (Arnst, 2008).

With cutbacks our clinic has to make decisions on what clinical services we should cut that want have a major effect on our patients. Randall et al, developed a tool call the informed decisions toolbox, which helps managers make better evidence informed management decisions. This process involves six steps and these include: framing the management decision, finding sources of information, assessing the accuracy of the information, assessing the applicability of the information, assessing the accountability of the evidence and determine if the information is adequate (Randall et al, 2007).

According to research, between 70 and 80% of health care costs are due to caring for patients with chronic conditions and the cost of health care continues to rise by more than 6% each year (.http://www.knowwpcarey.com). So that is why some health care economists discuss bending the cost curve will reduce the rate at which health care spending increases. The care management process involves using a patient registry which will include a database with the patient's conditions. The database will also be able to give the patient helpful educational material, give feedback from the patient to their doctors and hire nurse care mangers to oversee the care of the patients (http://www.knowwpcarey.com).

Our primary goal will be to create a system in which payment incentives and regulations will the guide the delivery of the kind of health care we want which will include: care that is high-quality, sustainable and affordable (http://www.knowwpcarey.com). We will develop an accountable care organization (ACOs) which are umbrella organization that coordinate care among various providers and accept responsibility for the cost and quality of the healthcare they provide.

By using the toolbox, I have chosen to use framing the management question. So the question is why aren't physicians utilizing care management process? As the manager, I have decided to implement a

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