I will go to any lengths to get you to read this post, even if it means including totally gratuitous material like this photo of Holly Madison and her heavily insured breasts.
by James A. Bacon
Michael Martz is the guy that the Times-Dispatch assigns to important-but-boring stories about the nuts and bolts of state governance like utility regulation, health care exchanges and state retirement benefits. Today he highlights a McDonnell administration initiative for reforming (zzzzz) the way the state administers (Zzzzz) Medicaid-reimbursed (ZZZzzzzzz) mental health services (ZZZZZZ! Snort! zzzzz…)
It’s an important story. But, unless you’re directly involved in the mental health system, you’re not likely to click away from today’s Huffington Post story about the $1 million insurance policy that Holly Madison (pictured above) has taken on her breasts just so you could read about the state’s proposed new service delivery systems. (Come to think of it, if you did click away from the story about Holly Madison, you could be certified as legally insane in 14 different states.) Martz deserves credit for doing the yeoman’s work of explaining the state’s effort to make the system work better. As he explains:
The proposed new system would attempt to reduce the costs of the services to the Medicaid program by moving away from the traditional “fee for service” model to one that ultimately would have a private entity coordinating care for a contractual fee — and the risk that comes with it.
“The overall goal of the project is to improve the value of behavioral health services purchased by the Commonwealth of Virginia without compromising access to behavior health services for vulnerable populations,” said Cynthia B. Jones, state Medicaid director, in a memo to service providers last week.
One source of concern is that a third party contractor will add another layer of management and cost. But Secretary of Health and Human Resources Bill Hazel said the proposed coordinated care system would be different from the kind of managed care that most people are familiar with.”Managed care was all about the price,” he said. “It was the gatekeeper whose job was to say ‘no.’ … We want to ensure that individuals are getting the care they need in the appropriate setting when it’s needed.”
I have no idea whether this new arrangement will work, but we can’t continue doing what we’ve been doing. In stark contrast to Holly Madison and her bountiful assets, Virginia doesn’t have the money to throw at mental health. We have to experiment with new ways of delivering services and incentivizing providers and patients until we find something that works better. At least the McDonnell administration is trying.
