La.'s privatized Medicaid off to a rough start

by Heather Miller

Only 12 percent of eligible Medicaid patients have signed on with one of the state's five chosen private health care providers, which serves as a friendly reminder to heed the advice of the Public Affairs Research Council and keep a close eye on Gov. Bobby Jindal's new privatized Medicaid program.

As expected by the state Department of Health and Hospitals, the "Bayou Health" privatized Coordinated Care Network for privatizing Medicaid in Louisiana is off to a rough start.

According to The Advocate, approximately 12 percent of eligible Medicaid recipients have enrolled with one of five privately administered, publicly funded health insurance plans, which are slated to take over Medicaid coverage in February and have so far doctors and hospitals with endless unanswered questions about the new insurance:

Doctors, hospitals and other health-care providers have raised so many questions about how the new privatized program works that the state Department of Health and Hospitals, called DHH, started holding daily conference calls to try to clear the air.

Ruth Kennedy, DHH's deputy Medicaid director and Bayou Health point person, said the telephone wait time at the DHH call center this week hit 10 minutes or so before callers could talk to a live agent.

Plus, patients are reporting technical difficulties in their dealings with Bayou Health, which is supposed to help them as they make decisions.

Berkley Durbin, executive director of MedicineLouisiana, said some physicians' names are being incorrectly included as members of some health plan networks and some physicians names are not being listed on the health plan with whom they do have agreements.

State Department of Health and Hospitals Secretary Bruce Greenstein tells The Advocate that the agency expected to experience problems with the rollout, since "this is a pretty major change in the way we do business."

Indeed, the $2.2 billion privatized Medicaid program is a substantial change in the Medicaid business in Louisiana. As New Orleans' Gambit newspaper publisher Clancy Dubos points out in a December column, "Jindal is privatizing health care for a segment of the population that already ranks among the cheapest to treat. "

"If costs are already low, how will private insurers find room for profit?" Dubos asks in the column, also noting that Louisiana's largest private health insurer, Blue Cross/Blue Shield, opted against participating in the Coordinated Care Networks.

"In other words, the biggest player in the game concluded that there's no legitimate room for honest profit - essentially concluding that Louisiana's Medicaid program may not be so badly run after all," Dubos laments. "At a minimum, it's relatively cheap."

Read The Advocate's coverage here.