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Arizona's Medicaid system is effective

January 28, 2013
Deb Gullett

The Republic’s own “fact-checkers” would have a hard time finding the facts in Tom Jenney’s Medicaid column. There is so much at stake with the Governor’s decision to expand Medicaid and countless details still to be worked out; providing a venue for this sort of misinformation is destructive.

Jenney clearly never read the bill he trashed so relentlessly. House Bill 2045 is not a bed-tax bill. HB 2045 is a payment reform bill that was thoroughly vetted last year by the legislature. 

This year’s version completes the switch to a new way to pay for hospital services.  Simplistically, today hospitals are paid a daily rate for each day a patient is in the hospital. The longer the patient stays, the more money the hospital makes. 

Using this new diagnosis-based payment system, as envisioned in the legislation Representative Carter has worked so hard to advance, the financial incentive is to get the patient out of the hospital, not keep a patient there.   

Maybe people who want to perpetuate the current unsustainable system are not interested in measures like these that will pay for quality of care instead of quantity. Or maybe it's that they're just not knowledgeable enough to understand the issues. But this reform is a critical step toward more integrated, patient-centered health care in Arizona.

Jenney doesn’t know the first thing about Arizona’s Medicaid system.  The suggestion that our state’s Medicaid patients are shuttered off to a “low-quality, government-managed health insurance system with limited medical options” is preposterous. 

States across America are now trying to emulate Arizona’s model for patient-centered managed care, provided through an innovative public-private partnership where private health plans -- not the government -- coordinate the health care for their members. AHCCCS patients are treated in our state’s world-class institutions, such as Barrows Neurological Institute and Phoenix Children’s Hospital, through a fully integrated and highly acclaimed health-care delivery system. 

55,000 Arizona health-care providers treat AHCCCS patients, managed by private health plans that employ thousands of Arizonans. Members have their choice of a health plan and a doctor. This is first-tier care, not the second tier Jenney described. AHCCCS:

-Is continually ranked as having among the lowest per-member cost among Medicaid programs in the United States while still meeting high quality standards.

- Serves more than 75 percent of its long-term care members in the home or community–among the highest in the nation.

- Maintains the lowest pharmaceutical costs in the country and highest utilization of generic drugs.

- Is ranked America’s number one Medicaid program for individuals with physical and developmental disabilities.

Jenney sites unattributed “studies” that reveal generic “Medicaid” patients have bad health outcomes. In other states, maybe, but not in Arizona.  A truer and more responsible study of actual Arizona data makes precisely the opposite case. 

The study by the New England Journal of Medicine, citing the work of real health-care experts who scientifically reviewed Arizona-specific cases, shows Arizona’s providers are saving lives and delivering better health outcomes.

The governor’s bold decision to expand Medicaid deserves more -- a thorough and responsible examination of the facts using Arizona-based data and the homegrown expertise we have in abundance.

Deb Gullett is executive director of the Arizona Association of Health Plans.

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