The N.C. Hospital Association is rallying local chambers of commerce to pass resolutions in support of a provider-led Medicaid system that doctors and hospitals desperately want to keep in their hands.
The Garner Chamber of Commerce is one of 40 local chambers to do so. Garner Chamber of Commerce president Neal Padgett, said the chamber doesn’t usually dip into politics, but this was something that was important to the hospital chamber members.
“It was important for our local medical community, so we decided to do our part and listen in on the presentation,” Padgett said.
More than 1.8 million people in the state rely on Medicaid for their health care.
The state is considering whether to give the money that pays for the program to insurance companies or hospitals in a new bill when the budget comes out.
Local hospitals and health care providers say they are in the best position to do so effectively, and if the money instead gets in the hands of insurance companies, some hospitals may not get paid for all of their services.
For instance, when a person comes into the hospital for care, the hospital must care for them, no matter the situation. Julia Henry, a spokeswoman for the NCHA said there are times when people come in for care they could have received from their physician. She said if hospitals were to have the money for Medicaid, then they could pay themselves for the service they would have provided.
Insurance companies on the other hand, she said, may say they don’t want to pay for the service they provided.
“We are motivated not to overspend on health care,” Henry said. “An insurance company has to pay shareholders something. If insurance companies are given the money, that money won’t go back into the system.”
Henry said the association believes it is important for the business community to understand why Medicaid matters to everybody. She said in the past few months her organization has been trying to educate the business community and encourage them to support their position.
“In the local community if a hospital has a high percentage of Medicaid patients it impacts their bottom line and it means that they have to find other ways to recoup the costs from underfunding of Medicaid,” she said. “And that means privately-insured patients and patients that pay out of pocket pay more for their care.”
Henry said by keeping the money in the hands of hospitals and doctors, they can better manage the funds and put the money back into the system where they can develop programs.
“Our goal is to try to make all of our community healthier,” she said.
Taylor Griffin, a spokesman for N.C. Medicaid Choice, said their goal is the same. N.C. Medicaid Choice is a coalition of insurance companies and managed care providers started to lobby or change in the way the state administers the program.
“What we like to see, and what we think is an approach that suits North Carolina, is a hybrid approach that allows both provider led entities and traditional managed care companies to participate in the reformed North Carolina Medicaid program,” Griffin said. “The idea is to have competition among different plans. Just like people do with regular insurance. It gives the state more options.”
Griffin said the model for traditional managed care companies has already proven effective, as 39 states are currently doing so.
“Provider led models are new and could potential be an effective part of the solution,” Griffin said. “But a hybrid approach allows the state to have the best options for providing improvements and quality for medicaid beneficiaries while protecting tax payers.”
Chambers have passed their resolutions and will now wait word from the General Assembly when the budget is revealed.