Medicaid changes target obesity, infant mortality and substance abuse

Medicaid changes target obesity, infant mortality and substance abuse
Alabama Medicaid Agency begins new program (Source: File video)

MONTGOMERY, Ala. (WSFA) - The Alabama Medicaid Agency has a new system to manage the care of most Medicaid recipients across the state that began Oct. 1. Medicaid leaders said this will result in patients receiving better care.

The Medicaid Agency’s Alabama Coordinated Health Network program will manage the care. Alabama Medicaid Agency Deputy Commissioner Dr. Robert Moon said they new program will target specifically obesity, infant mortality and substance use disorder in Alabama.

“Medicaid pays for over 50 percent of the babies born in Alabama," he said. "So we think if we can move the needle in infant mortality in Medicaid, we’ll be moving it for the state.”

The new program has care coordinators partner with a patient’s doctor. Moon said the care coordinator will follow up with a patient after their doctors visit.

“That works very well for the physician, because they don’t always have the staff to do that and if they have another resource that they can call in to help them do that, then that’s an advantage,” he said.

Moon explained that before the change, doctors had a partner to help but said those partners were not incentivized to make sure patients were getting the care they needed. A main part of this new program includes monetary incentives for the doctors and networks who manage the care coordinators.

“We want to give a recognition to that and say, well here’s another reason for you to be concerned about outcomes and how the patient actually experiences care and what are their health outcomes,” he said.

Moon said the physicians will be incentivized to provide better care and be cost-effective. The networks will also need to meet specific national metrics if they want to receive bonuses and other incentives.

“But to also incentivize quality outcomes for our recipients," he said. “To actually see patients get better because of this new program."

The care coordinators will also help make sure people get to their appointments. Moon said over time the program will probably save the state money. He said the cost savings are unknown at the moment.

Medicaid pays for the care of about 1 million people.

750,000 is the total number of Alabama Medicaid recipients who are potentially affected by the ACHN program for care coordination, according to Medicaid Agency spokeswoman Melanie Cleveland.

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