The San Antonio Express News gets saucy.
Albert Hawkins, executive commissioner of health and human services, told a House subcommittee that with the support of a 2003 law encouraging managed care, he wants to contract with HMOs to treat more of the state's more than 2.5 million Medicaid clients; contractors could be named soon.An individual who asked not to be identified, said he heard Toomey tell Hawkins: "Goddamit, Albert, I told you you should have rolled this (HMO shift) out before the session."
We'll just add this: "Goddammit San Antonio Express News, HMO's do not restrict access to care, they do not destroy the health care system."
Well said, Hope. Well said.
Actually, fee-for-service Medicaid in Texas is such a travesty that I (a good, card-carrying liberal) actually think managed care is a good thing for the poor and disabled in this state. For instance, FFS has no quality monitoring effort, but the managed care program is required by the feds to have an external quality monitor look at the care people get. In STAR+PLUS, acute and long term care are integrated and people get dedicated care coordinators looking at their entire range of care (even those on Medicare, as HMOs are required to provide care coordination to every member who needs it). The current managed care procurement required bidders to lay out their plans for all sorts of things that have never been done in FFS.
There have been issues around prompt payment, and providers do have to deal with multiple payors now instead of a single payor. I just don't think the state, on its own, would ever implement in FFS the kind of access and quality requirements it requires in the managed care program.