The state recently announced possible savings of $650 million by expanding competitive bidding for its Medicaid and MinnesotaCare business statewide. However, as a result, it will be shuttering two health plans that serve 475,000 low-income and disabled people, more than half of those who are on state health care programs. UCare and South Country Health Alliance (an 11-county health cooperative) would no longer exist to serve this population.
Historically, these two plans have been at the top as innovative, ethical and patient-centered. They have led the way in making Minnesota’s Medicaid system the envy of many states, and providing nation-leading care outreach to underserved populations.
It is hard to imagine that anybody meant this to happen. We need a “timeout” on the field.
Getting the best value for the taxpayer dollar is a good thing. Reducing competition in Minnesota health care by 40 percent is a bad thing.
Seeking cost-effective, quality care for our most challenged citizens is a good thing. Potentially disrupting the relationship of 475,000 patients and their doctors is a bad thing.
Sharpening our health care cost pencil to avoid waste and fraud is a good thing. Cutting health plan choices, which could cause major future cost increases, is a bad thing.
“Cheaper” may actually cost more. Many advocates are concerned about the impact of reducing options for 475,000 low-income patients and forcing them into new plans. Costs can increase when proper care is delayed because of hesitation over a new doctor, increased distance or loss of access to cost-effective outreach programs, leading to overuse of expensive emergency rooms. And with so many being forced to change plans, they are likely to encounter the same system problems that have plagued the MNsure health insurance exchange and get lost in a massive shuffle.
Will those millions in savings really materialize? For all its best efforts, the way the state calculates cost or savings in a state program is hardly an exact science. Fiscal estimates are often off by huge margins. Minnesota may or may not save all those millions, but if the state proceeds with this plan, we will definitely lose two outstanding health plans that have specialized in serving the unique needs of low-income and underserved populations.
Running state government is a complicated task. There is no need to cast blame. Sometimes, despite good intentions, things just don’t go quite as expected. But we must act. With eyes wide open to all of the impacts, we can make adjustments now to prevent these severe unintended consequences. We can make sure those most in need retain the option of choosing UCare and South Country Health Alliance.
It is time to call a timeout and reconsider the unfortunate results of this competitive bidding process. Let’s push the reset button and take a year to carefully consider all impacts.
For now, this year, all current plans that are willing should be allowed to participate at the prices set by the bidding process. We can immediately convene meetings about how to make next year’s process better, engaging legislators, the Department of Human Services, health plans, counties and patients themselves. And then all of the plans will have time to make improvements or adjustments.
Next year, we can move ahead more confidently with a process that avoids adverse impacts and advances Minnesota health care in the nation-leading manner to which we’re accustomed.
The Hippocratic oath states: Above all, do no harm. Minnesota would do well to follow this sage advice. Let’s take that timeout, and get it right.
Jim Abeler, of Anoka, is a chiropractor and former Republican member of the Minnesota House.