Plan to revise care is on pace

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COLUMBIA --- South Carolina's move to make Medicaid more like private health insurance plans with networks of providers is on track, the director of the state's Department of Health and Human Services said Wednesday.

For now, the state is spending about $97 million on transition costs, Emma Forkner told House budget writers, who wanted an explanation of what the state's getting and where it's going with health care programs for the poor, disabled and elderly.

While nearly $100 million is going into covering the transition, savings are already emerging, with $33 million in the fiscal year that ends June 30, Ms. Forkner said. She said savings should be $45 million next year.

"It's right on target with what we projected it to do," Ms. Forkner said after the hearing.

She said she's also ready to use federal stimulus money to help cover those costs and restore programs slashed when the state cut $1 billion from its overall budget.

Ms. Forkner said last month she went through a "gut-wrenching, painful and stinging" process of slashing prescription drug payments, restricting access to breast and cervical cancer treatment and halting construction of access ramps to homes. She also made it more difficult for people to qualify for Medicaid.

Ms. Forkner said the federal stimulus plan might help her cover transition costs faster but also will likely force her to reverse the cuts and changes. There might be enough money to cover the remaining transition costs, she said.

"We heard there are problems to deal with, but a commitment to deal with them," said Rep. Tracy Edge, R-North Myrtle Beach. "We got all the assurance we asked for."

ABOUT THE CHANGE

The state is moving people from the wide-open, fee-for-service operations that private sector employers dropped years ago as they moved to HMOs and provider group systems to save on health care costs. South Carolina now has about 57 percent of its Medicaid recipients in networks of doctors or providers that manage their care.

Some are calling for the wide-open option to be removed, saying it will save money by giving people more coordinated care.


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