About Bi-State

  Bi-State's Mission & Vision

  Board of Directors

  Calendar

  Career Opportunities

  Locations

  Staff Directory

Bi-State Members

  Member Benefits

  Member List

  Member News

Member Health Centers

  Find a Health Center Map

  NH Health Center Listing

  VT Health Center Listing

Media & Communications

  Feature Stories

  Media Events

  Press Releases

  Publications

Programs & Initiatives

  Community Development

  Government Relations

  Recruitment Center

Resources

  Articles of Interest

  Bi-State Reports & RFPs

  Conferences & Trainings

  Helpful Links

PROPOSED NH MEDICAID MODERNIZATION PRINCIPLES

May 2004

Draft

• Employ the World Health Organization definition of Health, “A state of complete well-being, physical, social and mental, and not merely the absence of disease or infirmity.”

• Provide access to necessary and appropriate health and social services to families with dependent children and to individuals who are aged, blind or disabled, whose income and resources are insufficient to meet the cost of services.

• Ensure communities play a role in the organization and integration of the health systems and the delivery of Medicaid health care services.¹

• Establish desired health outcomes as determined by well-defined indicators for measuring health.²

• Integrate the Healthy NH 2010 principles of disease prevention and wellness promotion with Medicaid reimbursement systems and methodologies. 

• Promote Medicaid recipients living with independence and satisfaction as contributing members of their communities.³

• Emphasize quality of care and focus on managing costs.⁴

• Promote systems that coordinate health-related nonmedical services with medical care to improve outcomes.⁵

• Promote and participate in a statewide organization that would develop innovative quality monitoring and improvement activities.⁶

• Invest in primary and preventive care to promote health and reduce the expense of costly interventions.

• Apply care coordination, case management, evidence-based practices, and chronic disease management practices that improve patient health outcomes and reduce unnecessary health care spending for high-cost and chronically ill patients.

• Ensure each Medicaid recipient has a medical home for coordination of medical and social services.

• Maximize state and community efforts to enroll eligible but unenrolled children.

• Promote improved access to oral health services.

• Encourage the federal government to assume full responsibility for the acute, primary, long-term and pharmaceutical care of the dual eligibles, individuals who are enrolled in the Medicare program but because of their low-income, are also eligible for the Medicaid program.⁷

• Reduce fraud and abuse by Medicaid recipients and providers to safeguard limited health care resources.⁸

• Coordinate benefits with Medicare and commercial insurers to ensure that Medicaid is the payor of last resort.

• Dedicate needed financial and clinical expertise to the DHHS leadership and administration of core functions that manage health care costs.

• Actively engage the federally-mandated Medical Care Advisory Committee in the Medicaid Modernization process.

• Publish the final draft of the proposed waiver for public comment prior to submission.

^1.  The New Hampshire Health Care System:  Guidelines for Change, DHHS, 1998.

^{2.  Ibid.}

^{3.  Ibid.}

^{4.  Ibid.}

^{5.  Ibid.}

^6.  Ibid.

^7. Medicaid Reform Principles Policy, National Governors Association 2003.

^8.  Ibid.