Medicaid managed care program in Louisiana stalled

By MELINDA DESLATTE

BATON ROUGE, La.

Louisiana's health secretary said he doesn't have a new schedule for when the Jindal administration plans to begin changes to the way the state delivers health care to the poor through the Medicaid program.

Concerns by health providers and lawmakers stalled the pilot program, which was supposed to begin in April and would run Medicaid as insurance-based managed care in three areas of the state, with a statewide phase-in later.

Health and Hospitals Secretary Bruce Greenstein on Monday said he doesn't know when the pilot program will start, but hopes it will be sometime in the summer.

"I don't have a timeline today, because I haven't worked one out yet," Greenstein told the Press Club of Baton Rouge when asked about the Medicaid revamp.

Greenstein said he intends to work with health care groups, providers and lawmakers to get their support for the insurance-based model, called "community care networks." Though Gov. Bobby Jindal unveiled the plans two years ago, Greenstein, who took office in September, said there hadn't been enough work with the groups impacted by the planned changes.

"The idea is to truly collaborate, and find the best system that fits our state," Greenstein said.

Under the program, thousands of low-income residents in Medicaid, mostly children, would be steered into the managed care networks that would be run by private companies, like insurers, who contract with the state and negotiate payments with health providers.

Currently, the state reimburses doctors, hospitals and other providers in the Medicaid program directly, giving a flat fee for each service rendered.

The Jindal administration said the new program would better coordinate care for Medicaid recipients, improve health outcomes by catching and treating chronic diseases earlier, and help rein in rising costs due to Medicaid fraud and overuse of expensive emergency room care.

But doctors, hospitals and other health providers in the Medicaid program have said the changes could discourage provider participation in the Medicaid program and could cost the state federal health care funding. A coalition of provider groups opposed the plan as it was proposed to begin in April.