Back in the 1990s, Americans learned that managed care was not the best way to control health care costs.
Because people paid less for health insurance, Health Maintenance Organizations became popular. We all thought HMOs were great, that is, until we got sick.
Then we discovered the downside. There were lots of medical procedures that HMOs did not cover. America turned away from HMOs, and for decades we didn’t hear much about them.
But history is repeating itself in Arkansas. Our Medicaid officials are learning the hard way that managed care is not the simple and economical solution they wished for.
The problem began when the governor told his administration, and his allies in the legislature, to save hundreds of millions of dollars in the Medicaid program.
They chose to institute a managed care system for people with developmental disabilities and people with chronic mental illness. In other words, about 45,000 of our most vulnerable citizens are the people most affected by the new managed care system.
Under a new plan developed by the Department of Human Services and Medicaid, the state will pay managed care companies a single fee.
The companies will be responsible for coordinating and managing all of their medical needs.
To some, it came as no surprise that serious problems immediately developed.
Physicians and pharmacists are waiting longer than usual to get paid, and they’re having to cope with confusing new billing systems.
Legislators are concerned about reports that some patients had to change primary care physicians, because their family doctor is not in the managed care network.
In short, we’ve witnessed the usual litany of problems that always occur when profit margins become the basis for making medical decisions.
Thankfully, there are lawmakers who are serious about setting things right. We’ve held three hearings in the past month, to demand accurate and responsive answers from the managed care companies.
It may take more time, but we will get this problem fixed.