By January Angeles and Judith Solomon in the Center on Budget and Policy Priorities blog
The Department of Health and Hospitals is seeking approval from the legislature to submit a proposal for a section 1115 Medicaid waiver to the U.S. Department of Health and Human Services (HHS). The state claims that the proposal would establish a medical home system like that described in the Health Care Reform Act. However, there are serious questions about whether the design of the Department's plan is appropriate or even possible for Louisiana, because Louisiana lacks the type of managed care organizations on which the plan primarily depends.
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In considering how to move the state forward toward its goal of a medical home system of care, the Louisiana legislature and other policy makers should give careful consideration to alternative approaches, which may be a better fit for Louisiana. In particular, Louisiana's current CommunityCARE program could be enhanced in ways that have been shown to improve outcomes and save money in other states. This alternative approach would be more suited to the state’s current health care environment and infrastructure, and have a higher likelihood of success.
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