INDIANAPOLIS (WOWO) — Indiana ranks 32nd among states in a new Medicaid report card from The Heartland Institute, which evaluates state programs on spending, eligibility policies, program integrity and health care provider conditions.
The report gives Indiana a score of 41 out of 100, compared with a national average of 45.5. Ohio ranked 13th with 54 points, while Illinois ranked 31st, Michigan 38th and Kentucky 41st.
The report evaluates 16 measures across four categories: program design and enrollment, fiscal sustainability, program integrity and administrative oversight, and provider-market conditions.
Indiana received 16 of 26 possible points for fiscal sustainability and 12 of 24 for program integrity. It scored 8 of 36 points for program design and enrollment and 5 of 14 for provider-market conditions.
The report identifies Indiana’s Medicaid improper payment rate as a major factor affecting its overall score. The state’s rate was 7.6%, compared with 2% in Ohio, 1.2% in Illinois, 3.3% in Michigan and 2.9% in Kentucky, according to the study.
However, the Centers for Medicare and Medicaid Services cautions that improper payments do not necessarily indicate fraud. They can include overpayments, underpayments or payments that cannot be verified because of insufficient documentation.
The report also identifies areas where Indiana scored well. Per-enrollee Medicaid costs fell about 2.8%, according to the study, and Indiana received full credit for its Medicaid Fraud Control Unit enforcement measure. The state also received points for operating an all-payer claims database, which collects health care claims information.
The Heartland Institute says Indiana could improve its score by addressing improper payment rates and eligibility redeterminations. The report also notes that Indiana received no points for early activity on Medicaid work requirements, while Ohio received points in that category.
The report was authored by Jack McPherrin, a senior policy analyst and research fellow at The Heartland Institute. It compares state Medicaid policies and administration but does not measure health outcomes, beneficiary satisfaction or every aspect of health care quality.
The full report and state-by-state comparisons are available at MedicaidReportCard.com.
