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Saturday, April 28, 2012

No need to rush Medicaid contract

Guest Editorial

Buried in the midst of a 154-item agenda, the state’s Executive Council last week took up the matter of privatizing the New Hampshire’s Medicaid system.

It was the second time the group has considered a contract for private companies to run the state’s health care system for people who are poor or disabled.

And it was the second time it has delayed a vote on the proposed three-year, $2.2 billion contract with three out-of-state managed care organizations.

The five-member council put off a decision because it wants to ensure that providers of long-term care will be able to weigh in on how the new system works.

Long-term care patients, such as people with developmental disabilities, are unique among the approximately 130,000 Medicaid beneficiaries in the state because their needs go beyond health care to employment, housing and community integration.

Despite pressure to get the wheels turning on the shift to privatization to meet a July 1 deadline mandated by the New Hampshire Legislature, the council is doing well to take its time on this matter.

Once under way, this far-reaching overhaul will affect not only those enrolled in the program and their families, but also hundreds of doctors, health care providers and social services agencies statewide.

State lawmakers project a $16 million savings in the first year if it’s implemented on time. But the council’s actions show its members are forward-looking enough to recognize this is not a process to be ushered through with only dollar signs in one’s eyes.

Once under way, the new system will shift management of Medicaid from the New Hampshire Department of Health and Human Services to contracted organizations, which would negotiate new contracts with heath care providers, such as nursing homes, mental health agencies and health care specialists.

After the contracts are signed, Medicaid beneficiaries would enroll in a plan with one of the managed care organizations and choose a primary care physician or “medical home,” a team of doctors, in the organization’s network.

The concern related to the long-term care patients is that their needs beyond health care are often met by local nonprofit agencies, which already have been squeezed from nearly every direction in the flurry of cost-cutting at all levels of government and across every sector in recent years. The managed care model used by 47 other states keeps these patients out of the for-profit managed care system.

With its decision to temporarily table the vote, the council has given officials a month to work through these details.

But if that isn’t long enough, we hope the councilors will hold on their thoughtful and correct course.

– Keene Sentinel