Restructuring Medicaid: Prevention and Managed Care

Amerigroup Corp., one of Virginia’s fastest growing companies, administers managed care plans for Medicaid and Medicare programs. Based in Virginia Beach, the company is finally doing business in its home state, taking on responsibility for 24,000 Medicaid patients in Northern Virginia, mostly young mothers and children.

The company’s forte is preventive care. The company has developed effective techniques for identifying and treating medical problems of poor people before they deteriorate into full-fledged medical crises that require expensive emergency-room treatment. Programs focus on prenatal care, treating asthma and other ailments common among the Medicaid population.

According to Marjolijn Bijlefeld, writing in Virginia Business magazine, studies have shown significant savings in other states. “In Ohio, for example, inpatient costs decreased 27 percent under Medicaid managed care. In Wisconsin, the savings were estimated at nearly 11 percent.”

Virginia needs to aggressively implement preventive care across the state. Given the enormous size of the Medicaid budget, savings could amount to tens of millions, perhaps hundreds of millions, of dollars per year. We don’t need to cut poor people out of the program; we don’t need to short-change doctors and hospitals. We simply need to re-think our model for delivering health government-backed health care.