Originally created 11/23/04

Georgia studies new program



ATLANTA - Frank Lopez has been on both sides of the divide when it comes to Arizona's version of the Medicaid program, which provides health care to people living in poverty.

As city editor of the Arizona Republic when his state became the last in the country to join the federal program in 1982, Mr. Lopez was in charge of the reporting on the genesis of the Arizona Health Care Cost Containment System. Some of those articles weren't so favorable.

"It was kind of a mess," Mr. Lopez said. "Things didn't work too well."

Now, as public information officer for the Arizona system, Mr. Lopez touts the benefits of the program, which he says has recovered from its early problems and become an effective way to provide health care for lower-income Arizonans.

The unique aspect of Arizona's program, and one that other states have begun to repeat with mixed results around the nation, is that it was a managed-care program that enrolled Medicaid recipients in health-maintenance organizations (HMOs) or similar arrangements.

Under Gov. Sonny Perdue, Georgia has become the latest in a line of states to consider changing its Medicaid program to something more closely resembling Arizona's. Mr. Perdue's plan would move more than 1 million Medicaid and PeachCare recipients into "care management organizations," similar to HMOs. Only beneficiaries in long-term-care facilities would be exempt from the change.

That makes the ups and downs of the Arizona plan and similar systems of particular interest to Georgians. For those enrolled in the Medicaid program, the experiences in other states could be a sign of what's to come in Georgia. For doctors and other health care providers, it's a hint of how they might relate to the Peach State's program in the future. And for taxpayers, who are supposed to save money as Mr. Perdue's plan limits the growth of health-care costs, there are signals as to why the governor's arguments might be right - or wrong.

While advocates of managed-care Medicaid point to Arizona's program, opponents cite TennCare - a program that faces dissolution after it proved too costly.

For their part, Georgia officials stress that the Peach State's plan is its own program.

"We want to create a system that is unique for Georgia and works for Georgia," Kathy Driggers, the chief of managed care and quality for the Department of Community Health, told the board that oversees the state's public health-care plans.

But even so, officials from Arizona, Tennessee and other states say there is a lot that Georgia can learn from a program that has stood the test of time and another on the brink of collapse.

"TennCare tried to expand coverage beyond what was already there," Dr. Christopher Stround, a member of the Georgia Board of Community Health, said after Ms. Driggers' presentation. "We're not."

Reach Brandon Larrabee at (404) 681-1701 or brandon.larrabee@morris.com.