GUEST EDITORIAL
By Loren Heal, The Heartland Institute
The California version of Medicaid, called Medi-Cal, will mandate the enrollment of about 400,000 of its patients in a state-sponsored managed-care plan over the next year.
The plan, designed to help the state cope with rising Medicaid costs, will effect Medi-Cal patients in San Francisco and fifteen other counties. California obtained a waiver from the U.S. Department of Health and Human Services in November 2010 to make the move, which local officials say will save the state approximately $365 million a year.
Other States Consider Managed Care
John Graham, director of health care policy studies at the Pacific Research Institute, said managed care in Medicaid is one method states are considering in order to save costs while increasing access.
“It’s a good idea. Traditional Medicaid fee for service is ineffective, because rates are too low, and the government bureaucrats—federal, state, and county—are not capable of determining the correct price or fee to pay for service,” Graham said. “So we are seeing decreasing access to doctors and medical services for Medicaid recipients.”
Graham says managed care solves some problems within Medicaid, but hardly all of them.
“The advantage to managed care is that the government gets out of price-fixing. Now the devil is in the details, so states are going to have to be sure they have a contract with a managed care provider in a transparent way so that the taxpayers can see who bears what degree of risk in that contract,” Graham said.
Republished with permission from The Heartland Institute
