Monday, June 27, 2005
South Carolina moves forward with Medicaid reform
[Roddie Burris, "Medicaid changes sought," The State, 21 June 2005.]
South Carolina is joining Florida as one of a handful of states that are taking bold steps to reorganize and revitalize Medicaid as a sustainable and effective program:
“Beneficiaries aren’t even involved in the process right now,” said Robbie Kerr, director of the state Department of Health and Human Services, which oversees Medicaid in the state.
In the waiver request sent last week to the federal Centers for Medicaid Services, Kerr contends the lack of consumer involvement is a major factor in the state’s rising Medicaid costs.
Under the waiver, most S.C. Medicaid recipients would be given a personal health account. That account would be used to select and pay for a coverage plan, ranging from those with low premiums and high deductibles to full-service programs.
Whatever is left over after paying for a coverage plan would go on a debit card that would have controls to restrict its use to purchases of medical services.
The monetary value of each personal health account would be based on a profile of the individual Medicaid recipient, including age, gender and physical condition.
Officials say health care providers, pushed by competition, will devise new options if consumer choice is part of the Medicaid system.
Beneficiaries then could use the debit cards for whatever medical expenses are most important to them — including co-pays, other office visits or extra prescriptions.
“It will be a completely different role for us,” said Gwen Power, HHS special projects director. The agency would begin the shift to quality assurance and accounting for coverages, she said, rather than administer the program.
Gov. Mark Sanford is behind the Medicaid overhaul.
“Such change is vital to the long-term fiscal health of Medicaid and physical health of the program’s beneficiaries,” Sanford said in a statement.
“We’re all one step away from Medicaid,” Kerr said. Medicaid recipients “are like you and me. They think like you and me and will make choices like you and me. Why wouldn’t we give them the same choices?”
[Matthew Hisrich, "A Backgrounder on Kansas Medicaid," The Flint Hills Center, 19 July 2004.]
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