Beebe seeks to get out front in Medicaid debate

Editor’s note: Roby Brock, with our content partner Talk Business, wrote this report. He can be reached at [email protected]

With voter unrest and fear regarding federal health care reform, Gov. Mike Beebe wants to avoid the association in his efforts to overhaul the state’s Medicaid system.

In his most recent weekly radio address, Beebe took pains to draw the distinction between federal reforms and his state initiative.

"Federal health-care reform has created a lot of controversy and division in our country and in our State, and the fate of that law will likely be determined by the U.S. Supreme Court. Our efforts in Arkansas have nothing to do with that law. We must take action regardless of how those legal battles play out. In fact, I want to do in Arkansas what I felt the federal government should have done in the first place: get health-care costs under control," Beebe said.

The Governor is asking federal health care officials to allow Arkansas to experiment with its Medicaid program in order to corral costs and, in theory, create better health care outcomes. In one of his clearest explanations of how he wants to fundamentally change Medicaid, Beebe noted in his weekly address that the current health care payment system emphasizes treatment over results.

"If you are a health care provider, you are compensated based on the volume of tests, treatments and referrals you can administer," he said. "In Arkansas, we want to put greater emphasis on results, to base more payments on making patients better, not just treating them as much as possible."

One of the major reforms Beebe wants to try involves the creation of "medical homes" or "health homes." These "homes" would create care-taking teams throughout the state. Their efforts would stress more comprehensive, holistic health care treatments versus the battery of tests and referrals now deployed throughout the system.

A recent study released by Arkansas Children’s Hospital and the University of Arkansas for Medical Sciences provides an example of the "medical home" concept. It was part of a children’s clinical intervention program created in 2006 to deal with kids suffering from severe chronic medical conditions.

According to researchers, the study of 225 Medicaid-eligible pediatric patients found savings of $1,179 per patient per month for a full year after the first clinic visit. The research team estimated that normal Medicaid payments for the children involved would have been $12.7 million, but with the "medical home" concept, the costs totaled about $9.5 million.

Some of the kids in the study were born with birth defects resulting in Down’s syndrome, cerebral palsy, and other chronic neurodevelopmental disabilities.

The Children’s Hospital "medical home" program said it used "a multidisciplinary approach" to improve outcomes and lower costs.

During clinic visits, the "medical home" team consisted of a specialty nurse, nutritionist, social worker, speech pathologist, developmental psychologist and physician. The team evaluated the children’s medical, nutritional, developmental and psychosocial conditions. Therapy plans and follow-ups were formulated and communicated to the child’s primary care provider, according to the ACH study.

The health plan for each child was summarized and converted into a document developed for each patient and provided to the family and other caregivers. The plan is continually updated and available electronically to the patients’ primary care physicians and other medical providers, the study noted.