BATON ROUGE, La. (AP) — Hospital and doctor groups are advising their members to be wary of signing onto a new insurance-based system the Jindal administration plans to use to change the way Louisiana delivers health care for the poor.
The head of the LSU hospital system and the president of the Louisiana Hospital Association also are warning that the changes to the Medicaid program could cost Louisiana hundreds of millions of dollars in lost federal health care funds.
The plan calls for “community-care networks” in three areas of the state by April, with a statewide phase-in the following year.
Under the so-called managed care program, a majority of the state’s Medicaid recipients would get health coverage through private insurance companies. The companies would choose to either receive a prepaid amount per Medicaid recipient signed or participate in a fee-for-service model, in which reimbursement is tied to care delivered.
Currently, the state reimburses doctors, hospitals and other providers in the Medicaid program directly, giving a flat fee for each service rendered.
Gov. Bobby Jindal’s administration said the changes will better coordinate patient care and reduce health care costs by keeping people healthier and out of hospitals. The program includes financial incentives to encourage preventive and primary care and to reduce health care costs.
However, LSU System Vice President Fred Cerise said the state loses opportunities to maximize federal health care funds under the managed care program. Louisiana Hospital Association President John Matessino said the state could lose $250 million or more.
The criticism hasn’t slowed administration plans to move to the community care networks.
“We expect there to be some concerns as things get more concrete,” said state Department of Health and Hospitals Secretary Bruce Greenstein. “But we believe this is the right way to go, and this is the way we are going.”
Four insurance companies so far have filed papers with DHH indicating they intend to offer insurance plans to Medicaid recipients.