Hochul’s Medicaid shake-up — if done right — could help both patients and taxpayers

 Gov. Kathy Hochul’s plan to boost competition for state Medicaid managed-care contracts could weed out some less-than-scrupulous operators and maybe save money down the road, but insurers are right to point out potential downsides.

Under the gov’s plan, the state would force Medicaid managed-care providers to compete for between two and five contracts per region. That could give regulators a chance to better vet players, improve services and rates and shut out those who try to game the system (say, by recruiting patients who don’t really need Medicaid services). Legitimate patients might wind up better off. Taxpayers, too.

Yet managed-care providers rightly note that the competition process itself will be expensive, time-consuming and potentially chaotic — for them, the state, health-care providers and patients. Indeed, some Medicaid recipients would be forced to switch plans, if theirs isn’t offered.

“This has the potential to be extremely disruptive,” warns New York Health Plan Association President Eric Linzer.

Limiting the number of managed-care providers to just five, at most, could also invite pay-for-play corruption, though that’s a danger with any contracting.

If Hochul’s plan (now part of her budget proposal) becomes law, the state will need to handle the transition carefully: Do whatever’s necessary to limit the chaos and expense (for insurers and state bureaucrats) of the bidding process. Guard against corruption by making the process fully transparent, with pre-established criteria for choosing winners.

And why on Earth does Hochul suggest considering whether plan providers are for-profit companies? If they offer the best product at the lowest cost, who cares if they make a profit?

All this, of course, amounts to a modest reform of a Medicaid program that costs more than $80 billion a year and, though meant for the poor, covers nearly 40% of the state’s population. But small steps for small feet.

Let’s just hope any improvements the state makes to this part of the program more than offset any damage it causes.

https://nypost.com/2022/03/05/hochuls-medicaid-shake-up-could-help-both-patients-and-taxpayers/