MONTGOMERY (AP) — Gov. Robert Bentley today announced his support for changes to Alabama’s Medicaid system that would affect one out of every five state residents.
The Medicaid Advisory Commission advocates changing the basic operating model from a fee-for-service system to a managed care program. Under the proposal, private-sector contractors would develop care networks in eight newly-created regions across the state.
The new framework would aim to offer better service to patients through regional operations that are responsive to local needs, Bentley said. Oversight would remain with the state. The state is served by 14 regions now.
“We now have the opportunity to turn Medicaid into a new system that is efficient and effective,” Bentley said. It would change the relationship among providers, consumers and the state government, he added.
The Legislature would have to enact new laws before changing the state’s Medicaid system.
Draft legislation would allow for the changes to take effect in October 2017.
With 35 percent of the General Fund budget now spent on Medicaid, the state is looking to keep costs contained. The commission’s proposals are aimed at saving about $50 million to $75 million per year. That amount would cover the annual increases required to keep the program at its current level, said Dr. Donald Williamson, the state health officer.
Supporters of the changes say that Medicaid money will be saved because emphasis will be on prevention, which they believe will reduce emergency room visits.
Health outcomes would be a part of the evaluation process the state uses to determine funding for the boards of each region.
“ER visits are not good for routine care. We want to provide wrap-around care so patients can be cared for in a way that will make many ER trips unnecessary,” said Williamson, who served as chair of the Alabama Medicaid Advisory Commission.
“We are looking for managed care to be the foundational program of Alabama health care,” he said.
Medicaid is a state-federal program that serves the poor and disabled. The Medicaid system in Alabama covers 53 percent of births, 43 percent of children and 67 percent of nursing home residents in the state.
Bentley, a Republican, has rejected expanding Medicaid under the new health care law to add 300,000 state residents to the rolls with the federal government picking up the total cost initially.
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