Rasmussen College State Limitations Peer Responses Discussion

There are several factors limiting individual state control of healthcare. Discuss what you feel is the most significant limiting factor and offer suggestions of potential positive reform to address this factor.

Respond to two or more of your colleagues’ postings in any of the following ways:

• Build on something your peer said
• Explain why and how you see things differently.
• Ask a probing or clarifying question.
• Validate an idea with your own experience.
• PEER RESPONSE 1
• The way I feel about the factors that are limiting the individual state control of the healthcare are, The states are autonomous,they create their own rules and laws for the healthcare of the state,they should be that way with healthcare instead of Uncle Sam having the control.Just like medicaid for example,even thought the state offers the program and benefits from having it, medicaid is still run by the government especially when it comes to the allotment of funds.
• PEER 2
• At the state level, the greatest limitation for state control of healthcare is cost.
  Much of healthcare reimbursement is governed by CMS, so it would be difficult to tailor this to meet individual state needs. I also have concerns about how an individual state-run program would facilitate cross-border travel. How would you meet the needs of a patient traveling out-of-state for care? There is already an issue with Michigan Medicaid patients needing to see a specialist 2 hours away in Wisconsin, but instead having to travel 10 hours to the nearest “in-state” specialist.

  Addressing the issue of cost, there will need to be cost-mitigation methods in place. Michigan is a shining example of quality improvement focused collaboratives – some owned by BCBS, some universities, etc – that incentivize organizations to perform well and reward OR punish based on quality based outcome metrics. A patient who quits smoking prior to having their surgical procedure will have a smoother recovery and cost less money to the insurance company/state.