If you have loved ones and friends who depend upon Medicaid services for their medical needs, you will want to read this.
Individuals in many states that have transitioned their Medicaid populations to a capitated managed care program have suffered these experiences:
Frail, elderly and disabled populations have suffered a disruption of medical services as well as poor care.
A shortage of primary care physicians to provide vulnerable populations with medical services, especially in rural areas.
The primary care physicians, to whom frail, elderly and disabled populations are often assigned by the state's program, have inadequate experience caring for patients with multiple chronic conditions.
A long delay before an appointment with a newly assigned primary care physician takes place because there is not space on the physician's schedule to add new patients.
A gap in the patient's medical information when moving to a new physician from the previous "specialists" who were caring for the patient.
These unwise states have sacrificed providing quality care for their older, frail and disabled populations to decrease state budgets.
What is capitated Medicaid managed care? Managed care programs are medical plans that pay health-care providers a set price (capitated) for each patient.
State Sen. Kim David, R-Porter, and Rep. Mark McCullough, R-Sapulpa, have authored Senate Bill 1495, which will do exactly that transition the Medicaid population to a capitated Medicaid managed care program.
In the early 1990s, the Oklahoma Legislature directed the Oklahoma Health Care Authority, which administers all state Medicaid dollars, to implement a capitated Medicaid HMO program for Medicaid recipients. The results were disastrous. The program could not sustain itself on the capitated price that the Legislature ordered the Oklahoma Health Care Authority to pay medical-care providers. The program cost more money than the state could or would pay. So the Legislature ordered the health care authority to return all Medicaid services to the previous "fee-for-service" plan.
Sensible states have implemented a capitated Medicaid managed care program that does not include their frail, elderly and disabled populations in the initial transition. These states also have used the lessons learned from a slow transition that often begins with either children or pregnant women who are receiving Medicaid services.
After transitioning other populations, wise states are saying, "No, the disadvantages of providing lower quality of care under a capitated Medicaid managed care program outweigh any marginal savings that the state might gain." These wise states are keeping their frail, elderly and disabled populations on the state's current Medicaid fee-for-service plan.
Please join the State Council on Aging in saying, "No!" to SB 1495.
Tell your state representatives and senators that you do not support SB 1495, or any other bill that would put Oklahoma's elderly, frail and disabled populations at risk.
Charles Clark of Ponca City is president of the State Council on Aging.