SETTING THE RECORD STRAIGHT: LaPolitics Column on Healthcare Reform in Louisiana
BATON ROUGE – LaPolitics publisher Jeremy Alford wrote a column entitled, “For Health Care Woes, Jindal Prescribes Confusion,” that misses on the facts on the administration’s reforms to hospital public-private partnerships, Medicaid, and the Office of Group Benefits.
Alford’s column was uninformed and ignored the facts on the administration’s healthcare reforms that showed healthcare access has been expanded, quality has gone up, costs have gone down, and graduate medical education has been strengthened.
Below are MYTHS in the Alford Column followed by FACTS to set the record straight.
MYTH: “But if we were to triage all of the administration’s health care-related woes, the privatization of Louisiana’s public hospitals would move to the front of the line… It seems like all of Jindal’s health care initiatives were sold as a panacea for rising costs, access to services and much more. But so far they’ve only caused a litany of side effects, which makes the administration look like it’s spinning plates and all of the rods are tilting.
• For decades, Louisiana had a state-run charity hospital system as the main safety-net health care delivery program for state residents in need. Faced with problems of growing costs in the charity system, antiquated healthcare delivery, along with major Medicaid cuts from the federal government, the Jindal administration took on the challenge of adapting a state-run hospital system into public-private partnerships.
• The charity hospitals were converted into public-private partnerships that would care for the most vulnerable, improve the level of care that’s offered and implement expanded services, all at an affordable cost.
• The new model of public-private partnerships sustains access to safety net care while supporting and improving graduate medical education in Louisiana, and lowering costs for taxpayers.
What Some Are Saying About The Public-Private Partnerships:
• “Shortened Emergency Room Waits And An Eliminated Prescription Backlog In Baton Rouge.” (The Associated Press, 9/13/13)
• “A Re-Established Gynecology Clinic In Lake Charles.” (The Associated Press, 9/13/13)
• “The Reopening Of Operating Rooms In New Orleans And An Orthopedic Clinic In Lafayette That Were Previously Shuttered By Budget Cuts.” (The Associated Press, 9/13/13)
• Longtime Patients Say The Hospitals Are Run More Efficiently. “Longtime LSU patient Brenda Davis, 51, attended the opening of the new Baton Rouge clinic. Davis, who has cancer in her lungs, said she receives the same level of care and compassion she received at the now-closed Earl K. Long Medical Center, but that things run more efficiently with Our Lady of the Lake in charge. ‘People need to know the good side of the change. It's been very positive. I thank God that it's still here, because they could have shut the doors down,’ she said.” (Associated Press, 9/12/13)
• Wait Times For Critical Prescriptions Have Been Cut From 10 Days To 10 Minutes And Delays At Emergency Rooms Have Been Dramatically Cut. (Times-Picayune, 9/3/13)
• Orthopedic Services Have Been Restored To The Lafayette Hospital. (The Advertiser, 8/15/13)
•The Lake Charles American Press Editorialized “The results, to date, have been remarkable here in our area. Moss’ emergency room has been converted into a an urgent care clinic that’s open 7 a.m.-10 p.m. daily, with Memorial assuming the ER duties…The changes have also added clinics at Moss specializing in orthopedics, breast health, gastrointestinal, pulmonary and cardiology…Any way you slice it, that’s a win-win proposition.” (American Press, 10/17/13)
• A Medical Center In Houma Is Now Providing More And Better Services Including New Mammogram Units That Will Save Lives. “In the past, the medical center had outdated units that required a special appointment for their use. Now testing can be done in a single visit with same-day results.” (Daily Comet, 10/14)
• “In Shreveport and Monroe, MRI appointment times have been cut from more than 60 days all the way down to one to two days, while the total clinic backlog has been reduced from 12,000 patients to 1,800. (The Advocate, 8/9/14)
• “From what originally was budgeted for $1.1 billion for the former charity hospitals in the fiscal year that ended June 30, the state spent $52 million less than anticipated. That’s a significant savings (about 5 percent), which provides a nice cushion for the new fiscal year.” (The Advocate, 8/9/14)
• The “Louisiana Legislative Auditor Calculated The Privatization Of Most Of The State’s Charity Hospital System Saves Taxpayers $271.2 Million In Salaries And Could Create Revenues Of $3.4 Billion.” (The Advocate, 1/1/14)
MYTH: “… the state legislative auditor is raising serious questions about Jindal’s privatization of Medicaid services through the Bayou Health program… Auditors doubt the savings that have been touted thus far and found “mathematical errors and inconsistencies” in a performance report that was prepared for lawmakers by the administration.”
• Bayou Health has saved $135.9 million in the program's first full year of implementation.
• When comparing Bayou Health to the old Medicaid system, the state is saving nearly $30 per recipient per month for its members, a greater than 12 percent reduction in costs.
• Louisiana’s adult population in Medicaid suffers from high rates of chronic disease that often lead to costly hospitalizations and emergency room visits. In order to combat this, Bayou Health helps people get necessary preventative care, stay healthier and make better choices. In its first year alone, more than 25,000 individuals received case management to help them manage their chronic or high-risk health conditions.
• Health plans also helped more than 63,000 of their members in their efforts to quit smoking, lose weight, gain access to dental and vision services and to purchase medical essentials such as prescription medications, child care supplies and more.
• There have been a number key quality measure improvements since implementing Bayou Health:
o The number of people between the ages of 18 and 75 with either Type 1 or Type 2 diabetes who came in for regular testing, which is critical to the control of diabetes, increased from 70.21% in 2011 to 77.03% in 2013.
o There has been improved access for members who are 20 to 65 years of age to ambulatory or preventive care visits from 78.35% in 2011 to 89.95% in 2013.
o The percentage of adolescent well-care visits for children aged 12 through 21 who had at least one comprehensive well-care visit increased to 46.48% in 2013 from 25.16% in 2011.
o This percentage increases even more for children ages 3 through 6 who had at least one well-child visit, from 67.46% in 2013 to 35.45% in 2011.
MYTH: “The emergency room [BR General] is hemorrhaging $1 million per month, due to an average increase of 400 patients. All of the new patients are uninsured, driven there by the administration’s decision to close down the nearby Earl K. Long Medical Center as part of the governor’s hospital privatization plan.”
• The Baton Rouge General-Mid City has been losing money for the last decade – prior to the current Administration and prior to any plan for a public private partnership.
• Its losses are not the result of a health care policy change, but a model of care that is extremely costly. The General could have chosen to serve uninsured without emergencies in a less costly setting by setting up an urgent care clinic or portion of the ER, but it didn’t.
• Although Baton Rouge General saw a higher number of uninsured recipients immediately following the closure of the Earl K Long, today the number of uninsured seeking care has dropped – Alford just simply chose to not divulge this detail.
• In the first quarter of the last fiscal year, the General had around $16 million in uncompensated care costs for uninsured, but that fell to $5 million by the end of the third quarter during the same year according to figures provided to the Department of Health and Hospitals by the General. This drop in uninsured costs shows that costs were stabilizing as the uninsured became more aware of the urgent care clinic and the partnership at Our Lady of the Lake.
• Additionally, the urgent care clinic in North Baton Rouge is seeing more visits per year than Earl K Long did in the year before it shut down — from 28,000 visits at EKL to 33,000 visits at the urgent care clinic. There is also more access to primary care and specialists for the uninsured in the network built out by the partnership, which means better doctors and better care up front to prevent dangerous health conditions in the future.
MYTH: "Critics, like Treasurer John Kennedy, argue the administration has treated the program's reserves like a rainy day fund, reducing it by $176 million last fiscal year. It held $237 million as of June 30 and could be to zero, according to Kennedy, by next year."
• OGB’s actuary predicts that OGB will have a $118 million fund balance and a $243 million cash balance at the end of FY15.
• That number is within OGB’s target range for a healthy balance and is entirely appropriate for a plan of OGB’s size.
MYTH: "Some in the program, now managed by Blue Cross Blue Shield of Louisiana, complain they're having to pay for the administration's mismanagement."
• OGB has been negatively impacted by Obamacare and the rising cost of health care.
• Obamacare will cost the state $24 million each year. That accounts for nearly half of the 5 percent premium increase that went into effect in July.
• A recent study of state health plans showed that Louisiana’s premiums are 15% lower than the national average.
• Despite rising costs, the administration is making plans look more like the quality plans that are typical in the private sector and offered by Blue Cross Blue Shield to its other customers.
• In the private sector, it is unheard of to have an HMO with no prior authorization. This new managed care method will coordinate services toward improving health outcomes and controlling cost for taxpayers.