December 08, 2011 Making Medicaid Better Newsletter 12.06.2011

- First enrollment opening nears for BAYOU HEALTH: A Message from Secretary Greenstein

Years of research, public discourse, hard work and late nights will soon culminate in the most significant transformation of Louisiana's Medicaid program in its more than 40 years of existence. In just one week, eligible enrollees in the New Orleans and Northshore regions will have an opportunity, for the first time, to make a choice about the way their health care is delivered. On Dec. 15, enrollment into BAYOU HEALTH begins, and the people we serve will choose which of five different Health plans best meets their needs and the needs of their family. As we near that hallmark date, I have been reflecting on the tremendous work that has occurred to get us here.

Doing nothing was not an option. Louisiana has long been on a predictable path toward failure. Just this week, the United Health Foundation once again ranked Louisiana as the second least healthy state in the nation. I believe our potential is more than 49th place. We have great providers and passionate leaders, but moving the dial on generations of poor health outcomes is no easy task. It requires a fundamental change in the way we do business. For the last four years, scores of dedicated individuals have been researching, designing, building and implementing an entirely new approach to care for Louisiana Medicaid and LaCHIP recipients. While we've had significant public discussion throughout this process, I understand it is only too easy to lose sight of the forest through trees. Therefore, it occurs to me that not everyone may fully understand the strength of the program we are launching.

A recent article in The Economist talked about how states are continuing to expand or (as in our case) introduce Medicaid managed care as means to bring smarter management and better coordination to their soon-to-be expanded Medicaid programs. At the very end was the following statement, "If states do not draft their contracts properly, or fail to be vigilant in monitoring patients' health, their experiment in managed care could be a disaster. On the other hand, if states are careful they could provide an answer to the question that has vexed America for years: how to provide good, cheap health care."

And here we find Louisiana's great advantage. I understand fully, from first-hand experience in other states, what the first part of that statement references. As with many programs, the early days of Medicaid managed care had their challenges. States made mistakes, and health plans took advantage of them. There were surely successes, but it's the failures that remain firmly planted in the forefront of many people's minds.  Louisiana is one of the last states with a large Medicaid population to implement Medicaid managed care, and we have built BAYOU HEALTH to be the standard-bearer of how to do it right and meet The Economist's challenge to find the answer.

Careful. Collaborative. Cautious. These are the words I'd choose to describe the process used to build BAYOU HEALTH. We learned from other states' mistakes, incorporated best practices and, in some cases, designed promising practices that you don't see elsewhere. From day one, our focus has first and foremost been on improving health; everything we have built into BAYOU HEALTH keeps that goal front and center.

As we finally move into the implementation and execution phase of this years-long endeavor, I felt it was important to reassure and remind our providers, partners and stakeholders of the strength of the foundation we are laying. What we are building together is the groundwork of Louisiana's health renaissance-the chance to make impactful change that will last for generations. So, below are 13 points I believe are the differentiators that will make BAYOU HEALTH the model that other states look to emulate. They underscore our intense focus on health outcomes, quality measures and consumer engagement. I am proud of our work together, and these are just the top-line highlights that make BAYOU HEALTH stand above all other Medicaid Managed Care programs.

Transparency. LDH will voluntarily publish and share BAYOU HEALTH metrics in ways that no other state has done. The list of all the reports is extensive.

 

 LDH schedules BAYOU HEALTH provider Q & A calls

 The Department of Health will host a series of conference calls Monday, Dec. 19, Tuesday, Dec. 20 and Wednesday, Dec. 21, to answer provider questions about the implementation of BAYOU HEALTH. Medicaid staff directly involved in the development of BAYOU HEALTH will be on the call to answer your questions. A brief introduction and update of the implementation will be provided by Medicaid staff, but the bulk of the conference call will be devoted to provider questions and answers.

LDH is asking that providers call in based on provider type, as noted below, to accommodate the limited number of call-in lines and ensure the most efficient use of call time. The conference call schedule is as follows:

If you are unable to participate on your assigned date, you may call in on another date. The call-in information is as follows:

To participate in a conference call please register by close of business, Friday, Dec. 16. During the registration you will have the opportunity to submit questions you would like answered during the conference call.

Systems issues are also addressed in LDH's recently released 834 Companion Guide, which addresses the file exchange requirements of the Enrollment Broker (Maximus) in conjunction with the CCNs, LDH and the LDH Fiscal Intermediary (Molina).

 

Plan Comparison Chart Posted

 

The official BAYOU HEALTH Enrollment website has been launched with many great features to help Medicaid and LaCHIP enrollees choose a health plan for themselves and their families.

One key feature that many people have been looking forward to seeing is the Health Plan Comparison Chart.

Feedback

If you have questions about Coordinated Care Networks, contact LDH's Coordinated Care Network staff at coordinatedcarenetworks@la.gov.  Learn more at MakingMedicaidBetter.com.

Surgeon General Ralph L. Abraham, M.D.

Secretary Bruce D. Greenstein

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