Utah's Medicaid program ranked No. 22 in a recently published national survey, but the director of the Division of Health Care Financing says the results cannot be taken too seriously, due to errors in the report.
In what Rod Betit called a search for the "ideal Medicaid program," the Public Citizen Health Research Group awarded Utah 202 points out of 350. The high score was Minnesota at 264, and Mississippi received the lowest rating with 133.Medicaid is a state- and federally funded "last-ditch" health care program for people who live well below the poverty level.
The report rated states on eligibility (100 points), services covered (125 points), availability of providers (20), service quality (40) and reimbursement policies (60).
Utah received its lowest percentage score in quality of care (40 percent) and its highest in availability of providers, followed closely by services covered and reimbursement policies.
But according to Betit, the report marks the state down for lack of programs or coverage that does, in fact, exist. For instance, Utah covers diagnostic services, preventive services and over-the-counter drugs, but the report subtracted points in those categories. It also criticized a non-existent $3 emergency room co-payment.
In addition to the rankings, the report made recommendations to Congress for minimum expectations any state Medicaid program should meet. Among other things, it said the federal government should pick up the entire cost of Medicaid, and eligibility should be based on the federal poverty level, with spend down (patients spend their own money to a certain point in order to qualify). The scope of benefits, it said, should cover all mandatory and optional services covered by the best of the state programs.
Medicaid should require a second opinion (recommending it is not enough), and clients should not have to make any co-payment. State administrations should have an increased state audit, as well.
"The report is interesting," Betit said, "but there are too many errors to give much credence to its validity."