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Wednesday, August 27, 2014         

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State's new Medicaid plan is aimed at improving care

The program will coordinate a patient's treatment through electronic records

By Leila Fujimori

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State officials unveiled yesterday a new way of providing and coordinating health care for Medicaid patients, particularly the chronically ill, starting in January.

Called "medical home model," the program integrates primary health care, behavioral care and social services for Medicaid recipients, said Department of Human Services Director Patricia McManaman.

"It's a system designed to treat the whole person, not just the disease," she said.

A key component is an electronic health records system to allow easy access to a patient's medical records wherever the patient goes in Hawaii.

One in 5 Hawaii residents is a Medicaid recipient, state officials said.

The patient-centered model provides a way to encourage comprehensive health services with coordination among doctors, hospitals, clinics and insurance companies.

The state pays health care providers who competitively bid for contracts to treat Medicaid patients.

The federal Center for Medicare & Medicaid Services administers the funding for the new program.

The state, however, will not require any health care providers to participate or tell them how to set up the integrated care.

State officials said the federal government will reimburse the state $9 for every $1 spent on the set-up costs for the first two years of the program, but could not provide an overall cost estimate.

"Our initial investment in and long-term commitment to implement medical homes will improve the quality of care for our people and save the state significant money in the long run," Gov. Neil Abercrombie said.

The new model will help the state get the most out of the money it spends, he said, adding that the private sector is also contributing to it, including the Omidyar Foundation.

Under the current system, a chronically sick patient might go from specialist to specialist without the doctors communicating about how they are treating the patient's diseases, McManaman said.

She emphasized that the state will try to encourage integrated health care by offering payments for the new program.

Federally qualified health care centers might already be close to providing this kind of integrated services, and qualified organizations could include a hospital, health insurance company or a network of doctors.






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