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by Jane Sneddon Little
January/Februrary 1991
Medicaid has become Massachusetts’ preeminent
budget buster. The largest single program in the budget,
it will most likely be the most important source of
spending increases between FY 1991 and FY 1995. But
Massachusetts is not alone. Medicaid is producing budgetary
headaches all across the country. This article explains
why the Medicaid program has become a substantial burden
for Massachusetts and other state governments and why
that burden is likely to increase. It examines why Massachusetts’
Medicaid expenditures are above average and outlines
some policy choices.
One option involves promoting best-practice delivery
and reimbursement systems to minimize unneeded care
and increase efficiency. However, because Medicaid operates
as part of state and national health care systems, it
cannot be reformed in isolation. Achieving ongoing savings
within Medicaid requires controlling costs throughout
the health care system.
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