Managed Care – Odd issue for the special legislative session

250px-Arkansas_State_Capitol_BuildingGovernor Asa Hutchinson called a Special Session of the legislature to begin on April 6. The primary issue is his rebranded expanded Obamacare, “Arkansas Works”. The issue is being presented in a Special Session because to keep the big government Obamacare program going he needs new legislation soon.

Governor Hutchinson also intends to push legislation to require a managed care model for disabled and mentally ill on Medicaid.

Pushing managed care in the special session is an odd decision. Special sessions normally are confined to emergency legislation and legislation that has a consensus among legislators.  Neither of these are the case with managed care.

Payments under Medicaid are now covered by the normal “fee-for-service” approach. Managed care is an approach where a company receives a fixed amount per Medicaid patient and would be responsible for the Medicaid recipient’s care. Managed care is touted as saving money by eliminating the incentive to run up charges with expensive procedures and unneeded tests.

The Health Reform Legislative Task Force (which was handpicked to ensure a favorable recommendation on continuing expanded Obamacare) could not reach a consensus on managed care and did not make any recommendation.  This task force should have been the group most favorable to the Governor’s agenda on Medicaid. Some legislators offered an alternative model they call “Diamond Care” but the Governor says his special session call will not allow their legislation to be presented.

Some oppose either model because of their concerns over increased bureaucracy and concerns that managed care could hurt the quality of care for patients.

If the managed care issue drags the Special Session into extra session days, you can count on the media to make a big deal out of how much each extra day is costing the state.

With no consensus among legislators and no emergency, the managed care issue should have waited for the 2017 Regular Session in order to allow more discussion on the issue.