Schweitzer speaks to health-care providers on Medicaid managed-care proposal

2010-11-09T19:48:00Z 2010-11-09T22:18:38Z Schweitzer speaks to health-care providers on Medicaid managed-care proposalBy MIKE DENNISON Gazette State Bureau The Billings Gazette
November 09, 2010 7:48 pm  • 

HELENA — Gov. Brian Schweitzer lectured health care providers Tuesday about his proposal to have a private company run part of Medicaid, saying he's trying to preserve the government health insurance program for the poor and save the state money.

At a Capitol meeting called by the governor, who invited the media, Schweitzer also made it clear he didn't appreciate critical remarks last month by providers who said they'd been left in the dark about the proposal.

"The sense of outrage that we should even consider doing such a thing!" he said sarcastically.

"My job is to try to find a way to continue to fund Medicaid," Schweitzer said, noting that federal health care reform calls for adding thousands of people to Medicaid in 2014. "As a manager of Montana's budget, I am worried. ... I'm trying to figure out how can we pay for this?"

Representatives of hospitals, nursing homes, physicians and insurers were invited to the meeting, where the governor spoke and then gave a PowerPoint presentation on how Medicaid costs in Montana are higher than in most other states.

Afterward, some provider representatives felt they'd been misled about the nature of the meeting.

"We were asked to come to a meeting to discuss managed care and instead were used as props at a press conference," said Rose Hughes, executive director of the Montana Health Care Association, which represents nursing homes. "It was clear the governor was not seeking meaningful input and failed to explain why his administration has not set up an advisory committee and embraced the concept of working with providers and consumers on this issue."

Dick Brown, president of MHA, the lobby for hospitals in the state, said he expected to hear more details about the Schweitzer administration's proposal — and that MHA and hospitals wants to work with the governor on that plan.

"Clearly, we still don't know (the plan details)," he said. "We'd like to know what the project is to be. The hospitals, the nursing homes, the physicians ... clearly would want to have an opportunity to discuss this."

The Gazette State Bureau reported last month that Schweitzer administration officials are preparing to ask companies to bid on a contract early next year to manage Medicaid in a five-county area that includes Helena and Great Falls.

State health officials said this managed-care pilot program could save the state money and improve health care quality for patients.

Under managed care, a private firm is paid a set amount of government money to "manage" care for patients covered by Medicaid. The company would make arrangements with physicians, hospitals and nursing homes and attempt to guide patients to lower-cost services. The company would get its contract payment and a cut of any savings.

Medicaid, the state-federal program that pays medical bills for the poor and the disabled, is a $900 million-a-year program in Montana. About 100,000 people are covered by the program in the state.

Anna Whiting Sorrell, director of the state Department of Public Health and Human Services, said Tuesday that her agency is continuing to examine the idea of the pilot program.

When asked if the agency plans any public hearings on the proposed bid offer, she said the agency will comply with appropriate state laws related to Medicaid.

Also at the meeting were executives from Blue Cross Blue Shield of Montana, the state's largest private health insurer.

Blue Cross spokesman Tim Warner said Blue Cross officials met earlier this year with Schweitzer administration officials about how to save the state money on health care costs and had asked to meet with the governor again after last month's news coverage of the managed-care proposal.

The Gazette State Bureau reported that state officials had been talking for more than a year about managed care of Medicaid with Centene Corp., a St. Louis-based managed care firm that operates in several Midwestern and Southern states.

"We were at the meeting (Tuesday) because we see an opportunity to save the state money and expenses though a partnership with Medicaid and the state," he said. "We're interested in learning more. We believe we could be a very good partner."

The demonstration project considered by the department would cover Medicaid patients in Lewis and Clark, Cascade, Chouteau, Teton and Judith Basin counties.

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