Republican leaders in Arkansas have been up in arms for months over Governor Mike Beebe’s efforts to work with federal officials to overhaul the state’s Medicaid program. The funny thing is that Mississippi Republican Governor Haley Barbour, Texas Republican Governor Rick Perry and the Republican Governor’s Association agree with Beebe’s Medicaid reform plans.
For background, Beebe has proposed moving the state away from a "fee-for-service" model to an "episode-based" system where clusters of medical providers work together to provide the most efficient patient care possible.
Why is he doing this? Because Beebe foresees a looming Medicaid crisis that could put the state’s Medicaid budget hundreds of millions of dollars into the red as early as July 2012. Rather than raising taxes, Beebe is trying to squeeze more efficiency out of existing tax dollars and he’s asked the federal government to give Arkansas waivers to that effect.
Beebe discussed the matter in his recent weekly radio address and brought up an important point regarding critics of his changes.
"There are those still trying to confuse the issue and tie our efforts to last year’s federal health-care-reform law for political reasons. As hard as they try, the truth remains that Arkansas’s efforts are our own. We must find a better way to pay for health care in Arkansas, regardless of the legal fate of the Affordable Care Act. We are stepping forward to address the problem before we are faced with the unwelcome choice of raising taxes or slashing services," Beebe said.
Many of the critics Beebe is referencing are Republicans who are trying to score cheap political points on this important state issue that affects tens of thousands of seniors, the disabled and low income families. The looming Medicaid crisis is not intertwined with Obamacare and would still exist if Obama’s health care reform plan was repealed or declared unconstitutional.
So it was nice to see one Republican, State Representative Nate Bell of Mena, linking to an important document in support of Beebe’s efforts on Tuesday. Bell, instead of posting tweets about Hitler and Nazis as he’s done in the past, brought the issue to my attention via Twitter.
Actually, Bell’s tweet ("Good ideas here!") referenced the Republican Governors Association’s Medicaid Reform Report. It is touted by 31 state Republican Governors, including Perry and Barbour, who says the document "should be taken seriously by anyone in Congress or the White House who is interested in saving Medicaid."
Here are a few of the recommendations from the report:
- Provide states with the flexibility, without requesting waivers or initiating the state plan amendment process, to pay providers based on providers meeting quality care and value-based criteria rather than the current fee-for-service approach.
- Provide states with the ability to implement bundling projects (a provider is paid an amount for a discrete event, such as a hip replacement, and that provider pays other providers for all necessary care for the event, with providers sharing in savings).
- Provide states the option of rewarding individuals who participate in health promotion or disease prevention activities.
After reading their recommendations, it’s clear the Republican Governor’s Association agrees with Mike Beebe on his plan to reform our state’s Medicaid program.
I’ll expect to see a pretty good portion of the other 45 Republican state representatives and 15 GOP state senators in the Arkansas Legislature join State Rep. Bell and Governor Beebe in enacting these needed Medicaid reforms.