Health Care

Commentary: Louisiana One Step Closer to Coordinated-Care Networks for Medicaid

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Judge’s ruling clears path for privatization plan and much-needed reform

In a crucial decision for the state’s health care reform agenda, a state district court has overturned an injunction against the awarding of coordinated-care Medicaid contracts to three private providers. Under the program, Making Medicaid Better, three providers – Louisiana Healthcare Connections, Inc., AmeriHealth Mercy of Louisiana, Inc., and AmeriGroup Mercy of Louisiana, Inc.,- will offer coordinated-care to 800,000 state Medicaid patients.

State District Judge William Morvant of the 19th District Court dismissed the injunction pushed by Aetna, Inc. Aetna has alleged errors in the awarding of funds to providers, leading to the temporary injunction.

This transition is necessary to reduce costs as the state faces an inundation of new Medicaid beneficiaries as a result of President Obama’s health care law, which raises the threshold of eligibility up to 133 percent of the federal poverty level.

Currently, Medicaid consumes $6.7 billion in annual state spending. Louisiana faces a projected 40 percent increase in Medicaid enrollment with the advent of ObamaCare, something the already overburdened economy cannot handle. Gov. Jindal estimates that transitioning towards coordinated-care will save the state $135 million annually. It would also lead to improved health care quality.

Under a coordinated-care network, patients choose providers and plans according to their costs and needs, which results in increased competition between providers and thus lower costs than under the rigid confines of government-administered Medicaid. It also facilitates preventive care, which alleviates long-term health care costs. This is especially important in Louisiana, which has one of the worst cancer percentages in the nation.

The fiscal challenges and uncertainties facing our state demand new solutions to persisting problems. A transition to coordinated-care networks is an imperative step towards securing a healthier, more efficient future for Louisiana residents.

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