Wednesday, December 3, 2008

Far-Reaching Medicaid Restructuring 

By Merrill Matthews, Jr.

Filed As:  Health Care

Gov. Bobby Jindal (R) has proposed to radically restructure Louisiana's troubled Medicaid program. The "Louisiana Health First" initiative, to be considered by the state legislature next spring, includes the following reforms:

• Starting "coordinated care networks" in all the state's major urban areas, including New Orleans, Baton Rouge and Shreveport, similar to private insurance managed care plans.
• Expanding statewide coverage of Medicaid health insurance benefits to some parents and grandparents in homes where children are getting coverage today. To be eligible, household income could be no more than 50 percent of the federal poverty level.
• Implementing a medical home model of care, including a variety of unconventional service delivery and reimbursement options, ranging from premium- based payment to shared savings, and a performance-driven system of care built on private insurance coverage, consumer choice, management of chronic conditions, earned incentives for healthy consumer behavior and ongoing measurement of system performance.
• Developing up to three "special needs" statewide case management/coordinated care networks designed around (1) children with special health care needs, (2) children in the foster care system, and (3) individuals with developmental disabilities.

If enacted by the state legislature and approved by the federal secretary of Health and Human Services, the program would become the most far-reaching state Medicaid restructuring in the nation.

• posted by Merrill Matthews
• 9:20 am
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