(1)The legislature finds that the current federal medicaid law and regulations have not kept pace with modern health care management practices, create obstacles to quality care and impose unnecessary costs on the delivery of effective and efficient health care. The legislature believes that the state of Idaho must strive to balance efforts to contain medicaid costs, improve program quality and improve access to services. The legislature further believes that the state of Idaho could achieve improved health outcomes for medicaid participants by simplifying eligibility and developing health benefits for medicaid participants according to their health needs, including appropriate preventive and wellness services.
(2)The legislature supports development, at a minimum, of the following health
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(1) The legislature finds that the current federal medicaid law and regulations have not kept pace with modern health care management practices, create obstacles to quality care and impose unnecessary costs on the delivery of effective and efficient health care. The legislature believes that the state of Idaho must strive to balance efforts to contain medicaid costs, improve program quality and improve access to services. The legislature further believes that the state of Idaho could achieve improved health outcomes for medicaid participants by simplifying eligibility and developing health benefits for medicaid participants according to their health needs, including appropriate preventive and wellness services.
(2) The legislature supports development, at a minimum, of the following health-need categories:
(a) Low-Income Children and Working-Age Adults with No Special Health Needs. The broad policy goal for the medicaid program for low-income children and working-age adults with no special health needs is to achieve and maintain wellness by emphasizing prevention and by proactively managing health. Additional specific goals are:
(i) To emphasize preventive care and wellness;
(ii) To increase participant ability to make good health choices; and
(iii) To strengthen the employer-based health insurance system.
(b) Persons with Disabilities or Special Health Needs. The broad policy goal for the medicaid program for persons with disabilities or special health needs is to finance and deliver cost-effective individualized care. Additional specific goals are:
(i) To emphasize preventive care and wellness;
(ii) To empower individuals with disabilities to manage their own lives;
(iii) To provide opportunities for employment for persons with disabilities; and
(iv) To provide and to promote family-centered, community-based, coordinated care for children with special health care needs.
(c) Persons with Medicare and Medicaid Coverage. The broad policy goal for the medicaid program for persons with medicare and medicaid coverage is to finance and deliver cost-effective individualized care which is integrated, to the greatest extent possible, with medicare coverage. Additional specific goals are:
(i) To emphasize preventive care and wellness;
(ii) To improve coordination between medicaid and medicare coverage;
(iii) To increase nonpublic financing options for long-term care; and
(iv) To ensure participants’ dignity and quality of life.
(3) To the extent practicable, the department shall achieve savings and efficiencies through use of modern care management practices, in areas such as network management, cost-sharing, benefit design and premium assistance.
(4) The department’s duty to implement these changes in accordance with the intent of the legislature is contingent upon federal approval.