Medicaid Managed Care Continues To Improve Care For New York's Beneficiaries

Main Category: Public Health
Article Date: 03 Mar 2005 - 0:00 PDT


New York Medicaid managed care plans continue to improve the quality of care for beneficiaries while keeping Medicaid cost growth below that of fee-for-service, according to a report released by the New York State Coalition of Prepaid Health Services Plans (PHSP Coalition). The report, "Medicaid Managed Care 2004 Quality Update" was prepared by Manatt, Phelps & Phillips, the national law and consulting firm. Manatt is counsel to the PHSP Coalition, a statewide association of 15 health plans serving the majority of New York's 2.5 million Medicaid managed care, Child Health Plus and Family Health Plus enrollees.

The data recently released by the state is unequivocal: Medicaid managed care has increased the number of quality providers available to Medicaid beneficiaries and improved the care they received. Findings include:

-- Access to and Utilization of Healthcare: Child and Adult access to and utilization of healthcare increased in all but one category over the prior year and exceeded the national benchmark in every instance;

-- Access to Board Certified Providers: Medicaid managed care beneficiaries in New York have access to Board Certified providers at rates which exceed national averages for commercial plans in the fields of primary and pediatric care;

-- Children's Health: New York Medicaid managed care plans continue to improve the quality of children's health, most notably in the appropriate utilization of asthma medications;

-- Women's Health: New York's Medicaid managed care plans exceed national benchmarks in key indicators for women's health, most notably in cervical cancer screening rates; and

-- Chronic Illness: Medicaid managed care also made significant gains in the management of diabetes and post-discharge follow-up for mentally ill patients.

The 2004 Quality Update follows a similar report prepared one-year earlier titled "Medicaid Managed Care in New York: A Public-Private Partnership that Works."

"Coalition plans are proud of the improvements in public health reflected in this report, and committed to further enhancing healthcare access and quality for low-income New Yorkers in the years ahead," said Harris Lampert, MD, chairman of the Coalition and president of Community Premier Plus, a private, not-for-profit health plan that serves medically underserved communities in Manhattan and the Bronx. "The success of the public-private partnership is a clear example of the level of quality that can be achieved through publicly subsidized health programs."

"This report demonstrates that we can provide quality healthcare benefits to New York's Medicaid enrollees while still containing costs," said Patricia Boozang a senior healthcare policy analyst at Manatt, Phelps & Phillips and staff to the PHSP Coalition. "Unfortunately, the Governor's proposed budget threatens to roll back the gains New York's Medicaid managed care program has made over the past eight years."

The report is especially timely in light of the Governor's budget proposals and their implications for essential healthcare services. Specifically, the 2005 Executive Budget contains proposals that will:

-- Eliminate the Facilitated Enrollment program, which was introduced by the Governor three years ago and effectively "privatized" the application process for New York's public health insurance programs. Today, 100 percent of Child Health Plus enrollees and more than 50 percent of Medicaid and Family Health Plus (FHPlus) beneficiaries apply through a facilitated enroller;

-- Slash Medicaid managed care and Family Health Plus premium rates; and

-- Reduce essential benefits, impose new employment-based eligibility exclusions and enact commercial level co-payments ranging from $20 to $250 for low-income working families who are eligible for the FHPlus program.

In 1997, Governor Pataki launched New York State's mandatory Medicaid managed care program with bi-partisan support in an effort to save state and local government money relative to the fee-for-service program system, while improving access to primary care providers, coordinating care for chronic conditions, and monitoring and improving healthcare quality. This report adds to the growing body of evidence that the state's goals of improved quality and financial savings are being met.

To receive a copy of the full report, please contact Patricia Boozang, senior health policy analyst at Manatt, Phelps & Phillips at (212) 830-7237 or pboozang@manatt.com

About the New York State Coalition of Prepaid Health Service Plans

The 15 members of the New York State Coalition of Prepaid Health Service Plans serve the majority of the state's Medicaid managed care enrollees. Sponsored by public and non-profit hospitals and community health centers and physicians, these plans have been serving New York's Medicaid managed care enrollees for more than a decade.

Coalition members include: ABC Health Plan, Affinity Health Plan, CenterCare, The Community Choice Health Plan, Community Premier Plus, Fidelis Care New York (NY State Catholic Health Plan), HealthFirst PHSP, Health Plus PHSP, Hudson Health Plan, MetroPlus Health Plan, The Monroe Plan for Medical Care, Neighborhood Health Providers, New York-Presbyterian Community Health Plan, Partners in Health and Total Care (Syracuse PHSP).

About Manatt, Phelps & Phillips, LLP

Currently celebrating its 40th anniversary, Manatt, Phelps & Phillips, LLP, provides legal and consulting services to domestic and international clients from offices in Los Angeles, Orange County, Palo Alto and Sacramento, Calif.; New York and Albany, N.Y.; Washington, D.C.; and Mexico City. Manatt's New York based Health Policy and Strategy Group specializes in helping health care entities navigate regulatory, operational and financial imperatives in the healthcare marketplace. For more information, visit http://www.manatt.com and www.manattjones.com.

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