November 30, 2005

Medicaid Reform Commission Meets For Last Work Session

Recently, the Missouri Medicaid Reform Commission met at the Capitol to finish work on crafting its recommendations. The committee’s report to the Missouri General Assembly is due Jan. 1, 2006.

The meetings were designed to condense the list of proposals, comments and ideas that the individual commission members want the group to consider. Staff from the Missouri Senate and Missouri House of Representatives now will write a draft of the final report. Sen. Charlie Shields, R-St. Joseph, the commission’s co-chair, did not set a date for the commission to review and vote on the final report.

Sen. Pat Dougherty, D-St. Louis, Rep. Yaphett S. El-Amin, D-St. Louis, and Rep. Margaret Donnelly, D-St. Louis, discussed their hearings in Hannibal, Kennett and Springfield. Members then addressed the themes and goals for the following key reform areas previously identified by the commission.

• access to quality care
  — require Medicaid recipients to have a primary care physician
  — create incentives for employers to provide insurance
  — find more ways to support federally qualified health centers
  — decrease the number of uninsured
  — promote best practices
  — increase the availability of practitioners in underserved areas
  
• provider participation and satisfaction
  — increase reimbursement rates
  — decrease administrative burdens on providers
  — decrease provider fraud
  — increase patient compliance
  — encourage alternative providers in delivering care
  
• wellness, prevention and responsibility
  — promote education and awareness of healthy habits
  — promote healthy lifestyles through incentives and disincentives
  
• mental health
  — improve patients’ choice of provider
  — redesign the care delivery system
  — expand local community support
  
• pharmacy
  — enhance delivery through electronic prescribing
  — increase copayments for more expensive drugs
  — promote the use of prior authorization
  — expand the pharmacy disease-management program
  
• eligibility
  — allow benefit design to vary by category of eligibility
  — re-establish the Medical Assistance for the Working Disabled program with more reasonable work requirements for participation
  — create a single point of entry for eligibility determination, including a 24-hour call center
  
• managed care
  — expand managed care to include mental health and the aged, blind and disabled populations
  — improve managed care plans’ care delivery
  
• technology
  — expand the use of health care technology
  — establish incentives for electronic prescribing
  — establish a nurse consultation hot line
  — increase in-home monitoring technology
  
• long-term care
  — redefine asset test standards, including reverse mortgages and valuation of property
  — encourage private long-term care insurance
  — increase quality in delivery of long-term care
  — emphasize treatment in the least restrictive environment
  
  Shields said all ideas will be classified in one of the following three categories.
  
• best practices that don’t require statutory change
  
• proposals requiring statutory approval
  
• proposals requiring a federal Medicaid waiver

Government Review Panel Member Now Hoping For Action
A co-chairman of the Missouri State Government Review Commission hopes the commission's report sparks discussion among lawmakers about the efficiency of state government. Warren Erdman, a business executive from Kansas City, acknowledges this report contains no sweeping changes like the last such commission report that recommended the current state government structure - paring down more than 100 departments to 12, for instance. Erdman says the main thrust of the report is a call for state departments and agencies to focus on mission, instead of process. Erdman says he's proud of the report that condensed what the commission discovered in 59 meetings, which included the testimony of more than 230 Missourians at 12 public hearings. The commission has offered 84 recommendations in its 30 page report delivered to Governor Matt Blunt.

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