In my post on personal health budgets, I featured a pilot program in the UK that is designed to test how flexible accounts can help improve care received by chronically ill patients. 

In the US, the personal health budget concept has been operating with success since 1998, when three state Medicaid programs began demonstrating the use of self-directed care budgets for frail seniors and persons with disabilities.  Today, some 15 state Medicaid programs offer self-directed care budgets for frail seniors and disabled adults and children. 

The $400 billion Medicaid program covers over 50 million low-income Americans, including several million frail seniors and adults and children with severe disabilities.  Medicaid, which is operated on the state level with a mix of federal and state funding, covers a wide range of health care services, as well as personal care services and home-based technologies to help beneficiaries live independently in their homes.

The self-directed care programs – sometimes referred to as Cash and Counseling – provide the option for beneficiaries or their families to manage a highly flexible budget.  Using the personalized budget, they may decide for themselves the goods and services they need to meet their daily personal care needs.  These include help with bathing, dressing, grooming, food shopping, errands, and meal preparation. They may also include home based technologies, such as a personal emergency response system or an automated medication dispensing service. The federal Centers for Medicaid and Medicare Services (CMS) recently clarified that state Medicaid agencies have wide discretion in the range of services and technologies that may be paid for using the self-directed budgets.

The Medicaid self-directed personal care budget option is extremely popular among patients, families, advocates, and care givers.  Evaluations have repeatedly shown positive results, including higher satisfaction, improved access and quality, and, in many cases, lower overall medical costs.

To learn more on Cash and Counseling, go here.

Kip