Bayou Health program kicks off
In spite of a few start-up problems, Louisiana health officials are expanding a new private sector health-care delivery system for the poor to cover another 300,000 people, most of them in the Capital and Acadiana regions.
Eligible Medicaid recipients in the Baton Rouge area already have received an initial mailing introducing them to the program, called “Bayou Health,” and the five private health plans wanting to take over their care.
Beginning Feb. 15, area Medicaid recipients will begin choosing which plan best suits their health-care needs and enroll in it.
The expansion comes as the Jindal administration keeps a time schedule that calls for statewide implementation of the program by mid-2012. Under the program, private companies take over $2.2 billion of the state’s Medicaid business and care of two-thirds of the program’s 1.2 million enrollees — most of them children.
Meanwhile, physicians and other health-care providers complain about the fast track the program is on and that the administration hasn’t fixed problems lingering from the first phase.
The first phase involved some 256,000 Medicaid recipients in an area that includes Livingston, Tangipahoa and St. Helena parishes and the New Orleans area. Beginning Wednesday, those Medicaid recipients will get their care through the private health plans’ networks of contract physicians, hospitals and other providers.
“We are fully confident that the process is in place and the launch will be successful,” state Department of Health and Hospitals Secretary Bruce Greenstein said. “Everyone is in a health plan and all notifications have been sent out.”
Greenstein said nothing he has seen so far has given him any reason to delay the next phase of the rollout. He said problems have been addressed as they come up and he is relying on physicians and others to help make the program successful.
Greenstein said the program will improve health-care outcomes and reduce costs by providing more coordinated care through medical homes. Opponents contend that the program takes badly needed money out of health-care delivery and puts it into the pockets of insurance companies.
As the first phase of the program starts, the state has not provided participating physicians with lists of which patients are being covered by what health plans, said Ashley Politz, executive director of the American Academy of Pediatrics Louisiana Chapter.
Many patients do not know to which primary care provider they have been assigned for care, particularly those who did not choose a plan and were then automatically enrolled in one, Politz said. They may know the plan but not their physician, she said.
Seventy-three percent of the Medicaid recipients in phase one were auto-assigned to health plans by the program’s enrollment broker Maximus because they did not choose one on their own. Twenty-seven percent — just over 65,000 Medicaid recipients — chose a plan, which Greenstein said is higher than the national average.
Lisa Faust, DHH communications director, said the agency is changing its approach in efforts to get people more familiar with “Bayou Health” and increase the numbers making health plan choices.
Instead of relying so much on large scale public events, Faust said, there will be “immersion” events where DHH staff will be in public health units, large provider offices, WIC clinics, Workforce One-Stops and Head Start centers.
Each of the five participating health plans was automatically assigned about 36,000 Medicaid patients. Of those patients who chose a plan, United Healthcare of Louisiana got the most, 21,039 participants. Community Health Solutions of America was next highest with 16,639 patients, and Louisiana Healthcare Connections Inc. was next with 13,437. The two other plans got fewer than 8,000 enrollees each — LaCare — owned by Amerihealth Mercy and Amerigroup Louisiana.
Politz said pediatricians are telling her that their patients continue to face long wait times when they call with questions about health plans and enrollment in them.
“One of my physicians said it was 45 minutes for one of his patients,” Politz said.
Faust said the patient probably was trying to get information through the state’s Medicaid call center, where waits can be lengthy, rather than the “Bayou Health” hot-line.