Louisiana Chapter of the American Academy of Pediatrics Joins the Coalition to Protect Louisiana’s Healthcare

November 18, 2010

Baton Rouge, November 17, 2010 – The Louisiana Chapter of the American Academy of Pediatrics (LA AAP) is the newest member of the Coalition to Protect Louisiana’s Healthcare, which was formed with the mission to protect healthcare services for the state’s most vulnerable patients.

According to Dr. Stewart Gordon, LA AAP Chapter President, “Louisiana’s pediatricians have serious concerns about the direction the Louisiana Department of Health and Hospitals has chosen in reforming the state’s Medicaid program. Ending CommunityCARE, when the existing system is improving health outcomes while saving precious public healthcare dollars, is short-sighted. Dismantling CommunityCARE will lead to increased costs in an already financially strained system. It will crumble the medical home for the 600,000 children currently depending on the program.

The LA AAP believes the current CommunityCARE program stands on its own merits. Most importantly, CommunityCARE allows the Medicaid patient and program to reap the benefits of care coordination, which everyone agrees is a key component of fiscally responsible healthcare. Care coordination allows a physician’s office staff to educate patients about their health, thus keeping them at school, work and home with their families. It specifically supports physicians in providing ancillary services for patients such as linkages for unassigned patients, referrals to specialty care, reminding patients of appointments, and rearranging clinic hours for maximum patient convenience and services. Care coordination is the future of preventive primary care medicine. Improving and expanding the CommunityCARE program, similar to North Carolina, has been proposed in past years by the LA AAP. North Carolina focuses on provider-driven measures of healthcare quality and care coordination for patients. A significant component of the model is that the providers are in partnership with the State. The State provides data in the form of utilization reports and works with providers to set measures that gauge performance and patient outcomes. Significant cost savings are realized when evidenced-based practices are supported by the State through policy and reimbursement methodology.

For the past several years, Louisiana providers have not had access to utilization reports related to our patient’s emergency room visits or provider specific reports about prescription usage. We feel both of these former programs likely demonstrated CommunityCARE efficiencies. During this same time period, the State has expended great energy and precious resources attempting to introduce a commercial managed care model that is not supported by those who provide patient care to Louisiana’s citizens. Most importantly, the commercial managed care model has proven to be more costly and more problematic in numerous states. Such changes in Louisiana would be irresponsible, especially given the current budget pressures on state-funded healthcare. Ignoring the investments made by primary care providers in CommunityCARE since 2003 would not be wise.

We welcome true collaboration with the administration and DHH to develop a better model for Louisiana. Louisiana has the basic components already in place, and it makes no sense to abandon a program that has demonstrated its worth. We believe healthcare providers have the solutions to improve our Medicaid program and look forward to doing so.”

In October, the Louisiana Ambulance Alliance, Louisiana Hospital Association, Louisiana State Medical Society, MedicineLouisiana and the Metropolitan Hospital Council of New Orleans formed the Coalition to Protect Louisiana’s Healthcare with the mission to protect healthcare services for the state’s most vulnerable patients. The Coalition represents tens of thousands of direct caregivers and healthcare employees throughout Louisiana and is deeply concerned about the recent and future cuts to Medicaid and the Department of Health and Hospitals’ original proposal for Coordinated Care Networks, which was developed too quickly and without input from the healthcare provider community, the legislature or other stakeholders.

On Nov. 5, the Coalition released recommendations for short, medium and long-term budget relief so that healthcare providers can continue to provide access to quality care to Medicaid patients. Specifically, the Coalition recommended using the extended Federal Medical Assistance Percentage, also known as FMAP, this state fiscal year to maximize enhanced federal matching funds; accelerating the use of financial mechanisms, such as the Upper Payment Limit program and Certified Public Expenditures; and exploring alternative funding sources currently being utilized and expanded in other states.

The Coalition is also actively working on an alternative model of patient-centered, coordinated care for consideration by DHH and the Louisiana Legislature that will not only put the patient first, but will also lead to cost-savings for Louisiana.

The Coalition is committed to working with Jindal’s Administration, the legislature and DHH on improving healthcare for Louisiana.

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