Medicaid Eligibility In Louisiana Gets High National Grade

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Medicaid Insurance in Louisiana

Poorer women and children in Louisiana are more likely to qualify for Medicaid health insurance care coverage than if they lived in all but 10 other states.

This finding was reported by Public Citizen, a national advocacy group, in a report entitled, Unsettling Scores: A Ranking of State Medicaid Programs.

Overall, the report ranked Louisiana's Medicaid program as number 28 in the nation. When compared to the 15 southern states, Louisiana ranks in the top five (this chart is available upon request).

The rankings are based on four key indicators: eligibility, scope of services, quality of care and provider reimbursement. According to the report, eligibility is the most important factor. "If a person is deemed ineligible for Medicaid, it matters little what services are available, how good they are or how equitably providers are paid," the report stated.

For eligibility, Louisiana ranked 11, behind only Rhode Island, Vermont, New York, Washington, California, Minnesota, the District of Columbia, Massachusetts, Wisconsin and Hawaii.

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"Without a doubt, Louisiana has a much higher rate of poverty, unemployment and poor health indictors than these states in the top 10," noted DHH Secretary Dr. Fred Cerise. "The fact that we have been so successful in enrolling children and pregnant women has helped our state get national recognition for ways to reform health care."

Over the past several years, organizations such as Families USA, the Kaiser Family Foundation and the Robert Wood Johnson Foundation have all applauded Louisiana's success in reducing the number of uninsured children in the state.

The state ranked 26 in Scope of Services. Louisiana's score was downgraded because it imposes limitations in terms of amount, duration, frequency or type of service in many areas. It also does not cover some services at all, such as physical or occupational therapy, eyeglasses, hearing aids or private duty nurses.

Quality of Care is the category that significantly lowers Louisiana's overall rank, 48. The survey reviewed nine indicators, of which five were of nursing home quality (staffing ratios, average number of deficiencies, homes without deficiencies, findings of actual harm/jeopardy and quality of care deficiencies). The other measurements were mandatory quality reporting, mental health services for children, fraud control efforts and childhood immunization rates.

"We have placed an emphasis on making sure that our children are up-to-date on their childhood immunizations by age two," said Cerise. "Today, we rank 32 in this important indicator, up substantially from previous years."

In the Reimbursement category, Louisiana ranked 30. This is close to the national average both in payments to Medicaid providers and in how Medicaid fees compare to those paid to Medicare providers.

Cerise called special attention to the reimbursement category, "I hope this report puts to rest the perception that Louisiana's Medicaid insurance program pays its providers lower than most any other state. Yes, we recognize that higher payments are needed to attract quality providers, but the report clearly shows we are close to the national average in how we reimburse providers."

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