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| | Healthy: Contrary to expectations, the new Medicaid expansion enrollees, even without any prior health insurance, were actually as healthy as the traditional Medicaid enrollees. |
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| | High premiums: But we also discovered that the actuarial premiums calculated were too generous - and this discovery helped the (delayed) recovery of several hundreds of millions of dollars. |
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| | Save money: Here’s an odd fact. 200,000 enrollees were in the Medicaid expansion population in 2014 and yet the state spent $28 million less than it would have spent if it had not opted for the expansion program. In other words, the state increased enrollment and the cost of the program for the state decreased. |
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| | High variations: Costs of treatment for people with the same medical needs varied by over 20% across the various counties in New Mexico. If costs could be brought to the lowest prevailing level, then the state could save over $100 million dollars annually. |
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| | Healthy pay more: In some counties, healthy people had a higher premium than those with diabetes and hypertension, exposing an inherent weakness in the actuarial premium calculations. |
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| | Focus on healthy: More importantly, the premium for a healthy patient was equivalent to the cost of 80 to 90 office visits per year. Even a 10% reduction in the premiums of healthy enrollees, which would still make it a fair compensation, could result in over $120 million in annual savings for the state. |
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| | Medicare pays less than Medicaid: The perennial complaint against Medicaid is the very low payments made to providers. We found that not to be true. If Medicaid were allowed to pay providers based on Medicare FFS then the state could save over $118 million annually. |
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