Newspaper article THE JOURNAL RECORD

State Medicaid Task Force Told to Emphasize Outcome

Newspaper article THE JOURNAL RECORD

State Medicaid Task Force Told to Emphasize Outcome

Article excerpt

Creating an efficient and effective Medicaid system will require the state put greater importance on outcomes than on counting the dollars put into the system, a panel of guest speakers told members of the House Medicaid Reform Task Force on Wednesday.

The task force heard about reforms made in Indiana and North Carolina, as well as reforms under way in Oklahoma to address mental health and substance abuse needs.

Medicaid is unfairly criticized by looking at cost drivers without looking at what's driving the costs, said Melanie Bella from the Center for Health Care Strategies, based in Princeton, N.J. If you just look at dollars spent on the programs, you get a better score if you cease smoking cessation programs, because people die faster, she said. It sound morbid, but it's a discussion we've been having a lot lately.

Indiana created a program to better manage treatment for chronic diseases, which account for the majority of Medicaid dollars spent on treatment. The program created a community-based infrastructure focused on strengthening the relationship between patient and health care provider. Patients were encouraged to take more responsibility for their treatment, and participation in the program was made as easy as possible for providers.

Though Indiana reimburses health care providers at the extremely low rate of 43 percent of Medicaid reimbursement rates, the program enjoys strong physician participation, likely due to the strong community infrastructure the program fosters, said Bella.

Better treatment for asthma and diabetes in particular resulted in fewer emergency room visits. An independent evaluation of the program found $2.1 million in cost savings for diabetes care over a three-year period, and $1.58 million in cost savings for asthma for calendar year 2002.

John Miall Jr. of Miall Consulting in North Carolina explained how the Patient Self-Management Program, a creation of the American Pharmacists Association, similarly reduced costs. …

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