Baton Rouge, Louisiana – The state health department intends changes in health plans. Governor Bobby Jindal’s administration informed lawmakers that the state needs to rework its way of paying the private managed-care networks which provide health services to 2/3 of Louisiana’s Medicaid patients.
Why Changes Are Needed?
The changes in health plans involve the Bayou Health program which is an insurance-based model. The program covers about 900,000 of the state’s 1.4 million Medicaid patients. Bayou Health provides urgent care mostly to children and pregnant women. However, the managed-care contracts are about to expire. With this, the Department of Health and Hospitals (DHH) is preparing for new bids from interested companies who want to participate in the said program. The new contracts are expected to take effect from February 1.
Stronger Health Care System
DHH Secretary Kathy Kliebert said that the intended changes will make a stronger system for the managed-care networks and providers. Kliebert emphasized that the stronger health care system will be most important for the patients. People rely on urgent care clinics most especially in times of emergencies, requiring immediate attention and treatment. This is the main reason why a better health care system is necessary.
Bayou Health Program
The Bayou Health program covers two models. In one area, the monthly premiums of Medicaid enrollees are paid by the state to their corresponding companies, while the services rendered are paid by the companies to the health care providers. In the second model, companies are paid by the state with a small management fee in order to coordinate patient care, although the state still repays health providers for services rendered. The changes in health plans tend to use only the premium-based model in its future contracts, although the second module covers more Bayou Health’s enrollees than the first model.
Patient-Centered Changes
The provision of an urgent care clinic facility and services to patients is significantly helpful for immediate treatment needs. Having a sort of an urgent care near me facility can ensure people that they will be provided with urgent treatment any time. The reworks in the state’s health plans will certainly affect the patients’ needs relatively. The changes will provide patients with more consistent treatments for chronic diseases, plus wider access to health services. Other plans also include the addition of hospital care benefits as well as non-emergency medical transportation for all the services provided through Bayou Health. Senator Francis Thompson added that changes in health plans and new contracts should mirror diversity, providing patients with adequate options.