Former HHS Secretary Tommy Thompson on Friday plans to release a "white paper" in which he recommends that the responsibility for long-term care of elderly Medicaid beneficiaries shift from joint state and federal funding to the federal government, the Washington Post reports. Thompson, who will speak to the National Governors Association on Saturday in Charleston, S.C., recommends that states focus on acute care for Medicaid beneficiaries younger than 65. In addition, he recommends that Medicaid begin to use electronic health records and other technologies to improve case management and health information collection. He also recommends that Medicaid beneficiaries receive education on health literacy and disease prevention. According to Thompson, the recommendations would result in long-term savings that states could use to provide health insurance for more uninsured residents, in some cases through subsidies for private coverage. "You want to set up almost a competitive environment where the states will strive to improve upon the healthfulness of their populations, and that will result in less costs for the states at the acute level," Thompson said, adding, "And as these people get older and they move over into the federal responsibility, they will be less expensive for the federal side as well, because you're inheriting a healthier population."

Reaction
CMS spokesperson Jeff Nelligan said that the agency will review the recommendations from Thompson. Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured and executive vice president of the Kaiser Family Foundation, said, "What any proposal lives and dies on is what the numbers look like, and there are no numbers in this proposal," adding, "Who pays and how much they pay is the critical issue in any Medicaid reform discussion." Kathleen Stoll, director of health policy for Families USA, said, "Medicaid could do more if there were more money from the federal level. It's a matter of federal priorities" (Lee, Washington Post, 8/3).