As the federal government increases its scrutiny of state financing of the Medicaid program, this paper, authored by a former CMS official, evaluates the existing financial management of the Medicaid program. Using existing models from the private sector and the government, the paper identifies alternatives to improve Medicaid's financial management without changing Medicaid's existing financing structure. The alternatives would reduce the Medicaid program's exposure to questionable practices, help control federal costs, and make the financial management of the program more comparable with that of the private sector.

 Report (.pdf)

 Executive Summary Table