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Decision Making; Medicaid Cuts

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Decision Making; Medicaid Cuts
Decision Making: Medicaid budget cuts

An emergency manager’s meeting was called this morning to announce the 2009 fiscal budget cut’s starting June 1, 2009. The North Carolina Department of Health and Hospitals has cut Medicaid payments for hospital services by 15 % to reduce the state 's budget deficit.These budget changes will directly affect private insurers with significant focus on the Medicaid recipients in the rural low income population located in Eastern North Carolina. During this called meeting a manager mentioned the Informed Decision Toolbox, she read about in an article for her graduate program. This article mentions steps or processes to help decide which services could be eliminated or introduced to continue to provide quality care on a reduced budget. The Informed Decision Toolbox (IDT) is an integrated set of tools that offer assistance to managers and policymakers in order to find best practice research supported by evidence- based models; and apply to healthcare organizational management structures.
IDT is organized into six steps that managers and policymakers should incorporate into evidence in formatting organizational decisions. The first step of IDT is to question the importance or relevance of the decision and consequences of the decision on those involved. In their article “Evidence-based Management,” Jeffrey Pfeffer and Robert I. Sutton describe the attitude required:
As with medicine, management is and will likely always be a craft that can be learned only through practice and experience. Yet we believe that managers (like doctors) can practice their craft more effectively if they are routinely guided by the best logic and evidence – and if they relentlessly seek new knowledge and insight, from both inside and outside their companies, to keep updating their assumptions, knowledge, and skills Harvard Business Review, January 2006, p. 64)
Currently, the clinic offers free drug and pregnancy screening, substance abuse counseling,



References: Evidence-Based Management. 2009. Retrieved May 23, 2009 from http://www.evidence-basedmanagement.com. Healthcare Governance Review. 2008. Retrieved May 23, 2009 from http://healthcaregovernancereview.wordpress.com/. Pfeffer, J, and Sutton, R. (2006, January). Evidence-based Management. Harvard Business Review. Rundall, T. G., Martelli, P. P., Arroyo, L., McCurdy, R., Graetz, I., Neuwirth, E. B., et al. (2007, September/October). The informed decisions toolbox: Tools for knowledge transfer and performance improvement. Journal of Healthcare Management, 52(5), 325.

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