Article on Medicaid had facts backward

By Deb Gullet – January 29, 2013
My Turn Column
The Republic –

he Republic’s “fact checkers” would have a hard time finding the facts in Tom Jenney’s Medicaid “My Turn”column on Saturday.

I appreciate that editorial pages strive to be provocative, but Jenney’s article was over the top. There is so much at stake with Gov. Jan Brewer’s decision to expand Medicaid, and countless details still to be worked out. Providing a venue for this sort of misinformation is destructive.

HB 2045 is not a bed-tax bill. HB 2045 is a payment-reform bill that was thoroughly vetted last year by the Legislature. This year’s version completes the switch to a new way to pay for hospital services.

Hospitals today are paid a daily rate for each day a patient is in the hospital. The longer the patient stays, the more money the hospital makes. Us­ing this new diagnosis-based payment system, as envisioned in the legislation Rep. Heather Carter has worked so hard to advance, the financial incen­tive is to get the patient out of the hospital, not keep a patient there.

Maybe people who want to perpetuate the current unsus­tainable system are not inter­ested in measures like these that will pay for quality of care instead of quantity. Or maybe it’s that they’re just not knowl­edgeable enough to understand the issues. But this reform is a critical step toward more inte­grated, patient-centered health care in Arizona. Second, Jenney doesn’t know the first thing about Arizo­na’s Medicaid system. The suggestion that our state’s Medi­caid patients are shuttered off to a “low­quality, government-managed, health-insurance system with limited medical options” is pre­posterous.

States across America are trying to emulate Arizona’s model for patient-centered managed care, provided through an innovative public­private partnership where pri­vate health plans — not the gov­ernment — coordinate health care for their members. AHCCCS patients are treated in our state’s world-class insti­tutions such as Barrow Neuro­logical Institute and Phoenix Children’s Hospital through a fully integrated and highly ac­claimed health-care delivery system.

More than 50,000 Arizona health-care providers treat AHCCCS patients, managed by private health plans that em­ploy thousands of Arizonans. Members have their choice of a health plan and a doctor; first­tier care, not the second tier Jenney described.

The Arizona Health Care Cost Containment System, which manages the health plans, is regarded as the na­tion’s “gold standard,” as Brew­er

said in her State of the State speech. As evidence, AHCCCS:

» Is continually ranked as having among the lowest per­member cost among Medicaid programs in the U.S. while still meeting high standards.

» Serves more than 75 per­cent of its long-term-care members in the home or com­munity, among the highest in the nation.

» Maintains the lowest phar­maceutical costs in the country and highest utilization of ge­neric drugs.

» Is ranked America’s No. 1 Medicaid program for individ­uals with physical and develop­mental disabilities. Finally, Jenney cites unat­tributed studies that reveal ge­neric Medicaid patients have bad health outcomes. In other states maybe, but not in Arizo­na. A truer and more responsi­ble study of actual Arizona data makes precisely the opposite case. The study by the New Eng­land Journal of Medicine , citing the work of health-care experts who scientifically reviewed Ar­izona- specific cases, shows Ar­izona’s providers are saving lives and delivering better health outcomes.

The governor’s bold deci­sion to expand Medicaid de­serves more: a thorough and responsible examination of the facts using Arizona-based data and the homegrown expertise we have in abundance.

Deb Gullett is executive director of the Arizona Association of Health Plans.

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