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Medicaid Plan Mirrors West Virginia's

Posted on: Thursday, 21 July 2005, 03:00 CDT

philk@wvgazette.com

It's no coincidence that proposals by the National Governors Association to reform Medicaid and reduce costs parallel efforts in West Virginia, an aide to Gov. Joe Manchin said Tuesday.

The preliminary plan, first released in June and a discussion topic at the just-completed NGA annual meeting in Iowa, includes a number of recommendations to reduce costs and improve efficiencies in the state-managed health care programs for the poor, elderly and disabled.

"Regardless of whether they're Republican or Democrat, all governors are concerned about the increasing costs of Medicaid and the need for flexibility," said Brian Kastick, Manchin's public policy director.

Although there was no formal vote, governors attending the conference expressed support for giving states greater control over Medicaid costs and benefits.

The NGA plan includes cost-sharing proposals, including co- payments and deductibles, intended in part to give Medicaid recipients incentives to seek less costly health care options.

In West Virginia, the Bureau of Medical Services has submitted a plan to the U.S. Department of Health and Human Services to immediately impose $3 co-payments for nonemergency visits to emergency rooms, and to go to a system of personal "health investment accounts" in 2006.

With the accounts, Medicaid recipients would be rewarded for healthy lifestyle choices, such as successfully completing smoking cessation programs, and would be penalized for wasteful expenses. Those penalties would be accessed for such things as nonemergency ER visits, missing scheduled medical appointments, or for opting for a brand-name pharmaceutical when a generic equivalent is available.

"Co-pays give us ways to encourage people to be more healthy," state Health and Human Resources spokesman John Law said Tuesday.

He said West Virginia's efforts to curb soaring Medicaid costs dovetail with other states' proposals, many of which are incorporated into the NGA plan.

"If you look at some of the recommendations from other states, they go along with what we're doing," he said.

West Virginia is cutting its Medicaid spending, which tops $2 billion annually in federal and state funds, by $115 million this year.

Nancy Atkins, commissioner of the Bureau for Medical Services, did not attend the NGA meeting, but briefed Manchin and gubernatorial aides who did attend prior to the meeting.

Manchin spokeswoman Lara Ramsburg said the session gave governors an opportunity to compare notes on what Medicaid cost-control measures other states are proposing.

"This is one of the steps toward real reform," she said.

While the governors attending the NGA were apparently unanimous in their endorsement of deductibles and co-pays to cut costs and discourage misuse of health services, the National Women's Law Center on Tuesday called cost-sharing an "especially troubling element" of the NGA plan.

In a prepared statement, center officials said previous attempts by states to impose Medicaid co-pays and deductibles produced initial savings, but ultimately increased health care costs for recipients who delayed seeking health care until they were critically ill.

"Imposing co-payment requirements on those who cannot afford them is counterproductive and harmful," said center Co-president Marcia Greenberger.

To contact staff writer Phil Kabler, use e-mail 348-1220.

Source: Charleston Gazette, The

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