Long-term care at crossroads, DHS says

Hire managed-care firm or augment Medicaid, agency chief tells lawmakers

LITTLE ROCK -- To control the cost of providing long-term care to the elderly, disabled and mentally ill, the state will need to hire a managed care company or spend more money to administer the Medicaid program, the director of the state Department of Human Services told legislators Wednesday.

If the state doesn't hire a managed care company, "we're going to have to have more capacity," Director John Selig told the Health Reform Legislative Task Force.

"We don't have the strength in our staff and the numbers at the right levels to do what a managed care company can do in terms of making sure that resources are used wisely," he said.

Selig, along with other state officials and members of industry and advocacy groups, spoke to the task force about ways to curb the cost of providing care to the disabled and mentally ill who receive Medicaid benefits.

The Human Services Department had planned to make changes in how it pays health care providers for those services, but special language attached to the department's appropriation bill in 2014 prevented the agency from implementing the changes until after Jan. 1.

Since then, department officials have said their plans for such changes are on hold while the task force, created by the Legislature this year, explores possible changes to the Medicaid program.

In May, the Human Services Department issued a request for information from managed care companies on how they could help the department coordinate care for the elderly, disabled and mentally ill.

Representatives from the nine companies that responded to the request testified at a task force meeting last month.

John Stephen, a consultant to the task force, told members that nearly half of the state's Medicaid spending in 2014 was for care of the elderly, disabled and mentally ill.

"This is the area of the population and the services you as a task force should really be focused heavily on," said Stephen, managing partner with The Stephen Group of Manchester, N.H.

Gov. Asa Hutchinson called on the Legislature this year to create the task force to study changes to the Medicaid program and recommend a replacement for the so-called private option, which uses Medicaid funds to buy insurance for low-income adults.

The Stephen Group is expected to present its recommendations to the task force by Oct. 1. The task force is is expected to make its recommendations by the end of this year.

NW News on 09/20/2015

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