Department of Health and Hospitals Secretary Bruce D. Greenstein today thanked the nearly 1,000 people who attended public forums held throughout the state during the past month to enhance the dialogue on Making Medicaid Better, and reiterated his commitment to reforming Louisiana Medicaid.
“I was so impressed by the energy across the state for fixing our broken system,” Secretary Greenstein said. “Over and over again, we heard from people frustrated by our current Medicaid system that places volume over value, quantity over quality. We are analyzing now all of the great ideas, critiques and feedback we received and are finalizing our plan, which we must implement quickly to improve health outcomes and bring financial stability into the state’s $7 billion Medicaid program.”
LDH held nine public forums in every region of the state to enhance the department’s dialogue on reforming Medicaid, with nearly 1,000 total participants. The first event, held in Baton Rouge in November, served as a statewide kick-off to the dialogue and was followed by eight forums in every other LDH region of the state. At each forum, the audience represented a mix of physicians, health care providers, billing professionals, health plan representatives, consumers and consumer advocates.
“Secretary Greenstein's willingness to openly engage the public on this critical topic that could eventually impact nearly 2 million Louisiana health care consumers is a great first step in the right direction,” said Moriba A. Karamoko, Director of the Louisiana Consumer Healthcare Coalition, who attended eight of the nine forums around the state.
Attendees at the eight regional forums heard from Secretary Greenstein and Medicaid Medical Director Rodney Wise, who explained the state’s vision for Coordinated Care Networks. The presentations were followed by question-and-answer sessions with Secretary Greenstein, Dr. Wise and other members of the Louisiana Medicaid staff.
“I have spent a lot of time with physicians across the state, and once we’re able to explain what Medicaid coordinated care really is, we see eagerness by so many to be part of the solution,” Dr. Wise said. “We know the provider community has a lot of questions, and these forums presented a perfect opportunity to get many of those answered. We will continue to meet with provider groups in the coming months as we work toward implementation of coordinated care.”
Other health care providers noted the forums were a chance to hear directly from the department on plans to improve the state’s health outcomes and to tell LDH leadership about the issues they see daily in their practices.
"Louisiana has languished at the bottom of health care for too long, and we can do better. With the state's plan, our providers and patients will finally have more tools to better manage their health and health care, and we can focus on primary care as the main weapon to treat and prevent chronic conditions and disease. We are also grateful that Sec. Greenstein has taken the time to continue the thoughtful discussion that has been taking place in our state for years. With input from providers included in their plan, it's time that we move forward with transforming our health care system,” said Ginger Hunt, founder and CEO of Primary Care Providers for a Healthy Feliciana.
At several forums, local healthcare providers offered attendees their own perspective on the importance of coordinating care. Their comments underscored the need to move forward with reforming Medicaid in Louisiana.
Dr. Gary Jones, CEO of Vantage Health Plan, at the Region 8 forum in Monroe on Dec. 7, said, "Anyone who lives in Louisiana ... you're aware of the many problems that Medicaid faces. I do believe that coordinated care networks will help to improve quality of care, it will help to improve or reduce the total costs, and you'll be able to take that money and pay providers more for the services that they do provide. “
At the Region 7 forum in Shreveport Dec. 8, Willie White, CEO of the David Raines Community Center, a Federally Qualified Health Clinic, said, "We know the system that we currently have, and the way the patients are accessing the system, are increasing costs. We've been on the frontlines providing care to the uninsured and underserved populations, particularly Medicaid, for a long, long time in this state, and we are really excited about the possibilities, and we are committed to working with the Department in seeing this system [CCNs] implemented."
In Lafayette, at the Region 4 forum Dec. 9, Dr. Suzanne Foster, a pediatrician with the Southwest Louisiana Center for Health Services spoke about the many challenges her patients, about 95 percent of whom are on Medicaid, face.
"My patients are stuck not receiving the care they need, so they're going to emergency rooms, they're having trouble in school, their parents are calling me to see about the status of the referral ... my patients get frustrated, my parents get frustrated. It [coordinated care] would put me in a better position to provide care to them [patients] because I would know they are seeing the specialists they need to see. It would help me to keep track of what's going on, if they are keeping appointments, that sort of thing," Dr. Foster said.
In Lake Charles, at the Region 5 forum Dec. 14, Dr. John Colligan, an obstetrician and chief health officer for the SWLA Center for Health Services, outlined the difficulty many physicians have finding specialists for Medicaid patients.
"People have to drive from one end of the state to the other, from Lake Charles to Shreveport, in order to receive specialty care. … Coordinated care networks have as one of their major and necessary goals the enrollment of adequate specialists so that they [patients] will be able to receive care here or close to home. I believe that the coordinated care networks will make a major improvement in this area if they are successful in engaging the specialists. … I do believe it [coordinated care] is a step in the right direction [for the Medicaid program]," Dr. Colligan said.
Many attendees offered ideas and feedback being analyzed now including such things as the process of appeals for consumers, solvency issues of health plans, billing and payment concerns of providers and continued transparency of the process.
“We plan to have a final Notice of Intent to bring to legislators by mid-January,” Secretary Greenstein. “From there, we will continue to work with stakeholders and legislators through the regular rulemaking process and issuance of a Request for Proposal for networks. We must move quickly and responsibly to implement this historic transformation of Medicaid in our state and ensure a healthier future for all of our citizens.”