In its final meeting of the year, the Arkansas Health Reform Task Force
today approved a draft of its final report on the future of Medicaid and the private option
is the draft of the report — due by the end of this year under the statute which created the task force.
Today's meeting was the third this week as the task force finalized its recommendations. The task force already voted on its two big-picture recommendations yesterday:
1) The task force endorsed Gov. Asa Hutchinson
's plan to continue the private option, pending negotiations with the federal government on some conservative tweaks that the governor wants to add to the program. This will maintain coverage for more than 200,000 Arkansans and projects to save the state coffers more than $400 million between 2017 and 2012.
2) The task force endorsed the governor's plan to save $835 million over five years in the traditional Medicaid program (that is, everything other than the private option), with a focus on high-cost populations — including long-term care, developmentally disabled, and behavioral health. That amounts to $250 million in savings for the state coffers (the feds cover 70 percent of these costs). The task force punted on the question of just how to achieve those savings
— whether via managed care, the patient-centered medical home model, or some other plan that provider groups come up with. The task force will debate the means to achieve the governor's $835 million goal in the coming months. The state's consultant, the Stephen Group, will evaluate the plans. Whatever the strategy is, the reforms are likely to involve a sharp move away from the current fee-for-service model: more care coordination, incentives for providers to provide cost-effective and high-quality care, and a "re-balancing" that would give more options for beneficiaries currently served by nursing home and other institutional settings to move into home or community-based care if those were more appropriate for their care.
The task force report
provides details on the task force's meetings and actions thus far, its findings on the private option and the traditional Medicaid program, and the two recommendations above. Here's the core recommendation: “We move to support the Governor’s efforts to negotiate waivers from the Centers for Medicaid Services (CMS) consistent with the Arkansas Works framework and we further agree that a minimum of $835 million over 5 years need to be saved from the Medicaid budget and we support further efforts to identify those savings.” For the record: The governor created the task force to issue recommendations; in practice, the task force recommended doing exactly what the governor wanted.
Because the debate is going to shift to how
to achieve recommendation #2, I think it's worth highlighting the report's findings on traditional Medicaid (after the jump). These are the areas of reform that the task force will be tackling next in aiming to meet the governor's benchmark. Note the importance of "re-balancing" (that is, less reliance on nursing homes) for Medicaid's programs serving those in need of long-term services and support