Senate Medicaid Committee meets to discuss Medicaid delivery options

Committee heard from health organizations and institutions

On Tuesday, the Mississippi Senate Medicaid Committee heard from eight speakers in a discussion of different Medicaid delivery options.

The Committee heard from:

Blanford with the National Conference of State Legislatures’ Health Program was the first speaker in Tuesday’s Medicaid Committee hearing. In May, Blanford released an article with NCSL stating that Medicaid accounted for nearly 30% of total state spending on average. She also noted significant enrollment increases over the course of the COVID-19 pandemic.

In the article, Blanford said policymakers are seeking other options on how to manage state spending on Medicaid programs. In front of the subcommittee, she described two types of Medicaid delivery systems: managed care and fee-for-service.

NCSL’s latest health policy report, “Improving Health and Controlling Costs in Medicaid—the 6|18 initiative,” highlights several options to improve health outcomes and contain evidence-based interventions identified by the the Centers for Disease Control and Prevention’s (CDC) 6|18 Initiative to help control costs.

Kidder followed Blanford. She has more than 20 years of experience working within the state Medicaid system. During her time, she has implemented programs, facilitated partnerships, and led quality assurance and process improvement efforts.

Kidder went over with the subcommittee how and why Health Management Associates transformed their Medicaid delivery system, what kinds of results they had seen, how they achieve those results, and briefly touched on the managing care challenges, noting the things they did to mitigate those challenges.

While both Branford and  Kidder brought more of a national perspective to the committee hearing, while Executive Director of the Mississippi Division of Medicaid brought a Mississippi perspective.

The Mississippi Division of Medicaid is a state and federal program created to provide health coverage for eligible, low income populations. All 50 states, five territories of the United States and District of Columbia participate in this voluntary matching program.

“A decade ago, advocates of reviving the mandated care delivery model in Medicaid may have sold managed care as a way to save money for cash-strapped Medicaid programs. But over time, Medicaid managed care has become more effective in serving other purposes,” said Snyder.

Snyder emphasized that Medicaid Managed Care does not result in national cost savings, but is providing a financial benefit to Mississippi’s General Fund. He stated that Medicaid managed care has been criticized by provider trade associations but it has been the vehicle used to preserve billions in supplemental funding to Mississippi hospitals.

Simpson, VP for Magnolia Health Plan, said that regarding health care, the cost of goods and services continue to rise.

As of September 2021, Magnolia had processed over 525,477 behavior and medical claims monthly. Magnolia’s financial accuracy for claims in 2021 was 99%.

Galatas, Plan President for Molina Health Care, shared that Molina had been working with their corporate teams over the last year and a half to engage more fully in what is happening in Mississippi. In her presentation, she stated that Molina had partnered with the Mississippi Department of Health to help with the vaccine efforts.

Parnell, Chief Executive Office of United Healthcare Community of Mississippi, shared that he thinks it would be beneficial to move toward a value based delivery model. Parnell stated that he believes it would be good to have certain mandates in place to have providers work with organizations.

The last two speakers of Tuesday’s Senate Medicaid hearing were representatives with the Mississippi Hospital Association:

• Richard Roberson, Vice President for Policy and State Advocacy/General Counsel
• Tim Moore, President/Chief Executive Officer

Moore said he and Roberson were going to share “unbiased, straightforward facts that are pulled from third party sources that you can look at and you can make the determination: are the taxpayers in Mississippi getting their money’s worth, is the system right, are the vendors right?”

Moore and Roberson said Mississippi state and local government hospitals have the 9th lowest national inpatient per diem expenses, adding that Mississippi non-profit hospitals have the lowest national inpatient per diem expenses and Mississippi for profit hospitals have the 6th lowest national inpatient per diem expenses.