A Reno attorney of my acquaintance sends out a daily email newsletter for his clients that included this article on Nevada’s Medicaid system:

Nevada Medicaid: Nevada’s Medicaid program was ranked 40th in the nation in a report released Wednesday, registering particularly low scores in the quality of care and the percentage of the population eligible to receive benefits. But Nevada ranked third in the nation in reimbursement, spending more per enrollee than the national average, a fact that encourages physicians to accept Medicaid patients, researchers said. The report, done by consumer advocacy group Public Citizen, ranked states’ Medicaid programs based on eligibility, quality of care, scope of services and reimbursement. Nevada is an especially interesting case because of its historically transient population, coupled with its scorching growth, Public Citizen health researcher Annette Ramirez said. “It’s growing so fast so some systems are lagging behind the actual need,” Ramirez said. Bottom five Nevada ranked among the bottom five in the nation in eligibility and quality of care. Its 46th ranking in eligibility reflects the state’s policy of covering only those at the lowest mandated income levels, the report said. This restricts access to care for many, including people made poor because of high medical bills. Such people are covered in states with more lenient eligibility requirements. RGJ Article [This article is actually progress. For years I have been pointing out that the news articles on Nevada Medicaid are extremely misleading. They consistently say Nevada is at the bottom (i.e. 48^th, 49^th, in the nation, etc.) in per capita spending on Medicaid. Until this article they have never reported that Nevada’s Medicaid spending per enrollee is much higher, more than 25% higher than CA for example. Medicaid is primarily a means based (or poverty) program. So the more poor people in your state the higher your per capita spending on Medicaid. Per capita spending is the amount of spending divided by the entire state population. The per enrollee spending is the amount spent per person on Medicaid. Despite having this pointed out a dozen times the paper never has accurately reported that Nevada is very high in per enrollee spending. In light of the track record I am extremely suspicious of the tone of the article and the other last in the nation type statistics since every time I have spend the necessary hours to investigate them they are very misleading. Why is Nevada’s per capita spending low? Because Nevada historically has had a low poverty rate (edged up in last couple of years) and a low unemployment rate (4.3%). This is a good thing not a bad thing. I took a brief look at the Public Citizen report cited in the article and Nevada is ranked in the middle group (not one of the ten “best” or the ten “worst”). They are a “health advocacy” group and I have several questions about their data and rankings. As a side note I noticed that the Health and Human Services Department finally acknowledged that they had a savings of $78 million (actually it is just a bit less of an increase) because caseloads have been declining (a bit of an understatement, but its progress). My guess is the $78 million should be quite a bit higher. ]

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