managed Medicaid will not save money
An ambulance waits outside of St. Anthony Hospital in Oklahoma City, Oklahoma, on April 8, 2020. (Tres Savage)

To the editors:

In a letter to you dated Feb. 19, Karma Robinson insinuated that managed care will improve outcomes in the Medicaid populations. That is one of the biggest lies being pushed in the fight. We have several thousand Oklahomans already enrolled in commercial managed care plans, and we rank 46th in health outcomes.

For an article in the Journal of Managed Care, dated Feb. 10, one of three “takeaway points” includes: “The research suggests that private managed care plans may have slowed state spending but have not improved beneficiary care and may have reduced access for certain populations.”


managed care

Letter: Medicaid managed care an opportunity to improve health outcomes by Karma Robinson

Looking at those words, I would suggest that private managed care organizations know they do not improve outcomes and do limit access to care. So don’t be fooled by words from a spokesperson being paid by large out-of-state insurance companies. Instead, look at the words from that journal article.

I would also point out that a majority of the 10 states with the worst health outcomes have managed care companies running their Medicaid programs.

The way they will hold down the cost in Oklahoma is by limiting care and cutting reimbursements to providers. The state told them in their bidders’ conferences to assume a 20 percent to 40 percent reduction in inpatient and out-patient services. So, they are going to limit care to the most vulnerable populations.

The final point against this idea involves the administrative costs. Currently, state employees run the Medicaid program for less than 5 percent administration costs. These out-of-state companies will get 10 percent to 15 percent administrative costs. The state will not save money with this program.

As the former executive director of the Oklahoma Association of Health Plans, I say managed care is not the solution.

Jimmy Durant
Director of advocacy, SSM Health St. Anthony Hospital
Oklahoma City

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