Gov. Kathy Hochul’s plan to spice up competitors for state Medicaid managed-care contracts may weed out some less-than-scrupulous operators and perhaps get monetary savings down the street, however insurers are proper to level out potential downsides.
Beneath the gov’s plan, the state would power Medicaid managed-care suppliers to compete for between two and 5 contracts per area. That might give regulators an opportunity to higher vet gamers, enhance companies and charges and shut out those that attempt to sport the system (say, by recruiting sufferers who don’t actually need Medicaid companies). Reliable sufferers may wind up higher off. Taxpayers, too.
But managed-care suppliers rightly word that the competitors course of itself will likely be costly, time-consuming and probably chaotic — for them, the state, health-care suppliers and sufferers. Certainly, some Medicaid recipients could be pressured to change plans, if theirs isn’t provided.
“This has the potential to be extraordinarily disruptive,” warns New York Well being Plan Affiliation President Eric Linzer.
Limiting the variety of managed-care suppliers to only 5, at most, may additionally invite pay-for-play corruption, although that’s a hazard with any contracting.
If Hochul’s plan (now part of her budget proposal) turns into legislation, the state might want to deal with the transition rigorously: Do no matter’s essential to restrict the chaos and expense (for insurers and state bureaucrats) of the bidding course of. Guard in opposition to corruption by making the method totally clear, with pre-established standards for selecting winners.
And why on Earth does Hochul counsel contemplating whether or not plan suppliers are for-profit corporations? If they provide the perfect product on the lowest price, who cares in the event that they make a revenue?
All this, in fact, quantities to a modest reform of a Medicaid program that prices greater than $80 billion a yr and, although meant for the poor, covers nearly 40% of the state’s inhabitants. However small steps for small ft.
Let’s simply hope any enhancements the state makes to this a part of this system greater than offset any harm it causes.
