In a week that Louisiana was ranked by several studies as having the lowest-performing health care system in the nation, including citations as having the highest number of avoidable hospitalizations, over-utilized emergency departments and among the highest rates of death in the nation and with among the highest costs, several Louisiana-based and national health care experts are supporting Louisiana Health First, a broad effort to overhaul the state’s health care system for the poor and uninsured.
As directed by the Louisiana Legislature, the Jindal Administration has drafted a broad waiver to address both transform the health care delivery system, while also attempting to confront several major financial issues unresolved by the state in past years - including $771 million in potential liabilities to the federal government and a looming cap on the state’s Disproportionate Share Hospital program. Louisiana Health First’s proposal to move toward a coordinated system of care has received the support of many organizations, including, among others: Blueprint Louisiana, the Council for a Better Louisiana, Louisiana Academy of Family Physicians, Louisiana Primary Care Association (a broad coalition of health centers for the poor), and Tulane University.
“I appreciate these leaders and groups taking the time to review our approach, provide input-which we have included in our efforts-and offer their support,” said LDH Secretary Alan Levine. “Even more so, I appreciate the family practitioners - one of our most important primary care groups - for their advocacy of an increased emphasis on workforce development, the pharmacists who voiced inclusion for independent therapy management and the physicians who want to secure health care quality by assuring that coordinated care networks will not cut provider rates. We have welcomed and listened to feedback and incorporated their useful input.”
Dr. James Campbell, president of the Louisiana Academy of Family Physicians, said, “The LAFP supports the concepts outlined by the Louisiana Department of Health and in its health care transformation document, Louisiana Health First, and, in so doing, acknowledges concerns regarding cost, efficiency and effectiveness of the current health care delivery system in Louisiana. The Academy advocates for patients to ensure that they received quality, patient-centered medical care, and has upheld principles to that end for quite some time. Many of those principles are set forth in the Louisiana Health First initiative.”
In a letter to Gov. Bobby Jindal, Rhonda Litt, executive director of the Louisiana Primary Care Association, Inc., said, “We believe the current health care foundation requires major modifications to service delivery, health information technology, disease management, preventive measures, medical home standards, and quality outcome measures. Therefore, we believe your proposed Louisiana Health First initiative has the best chance to strengthen the underpinning and move this State from 41st in health care quality and 50th in overall health.”
Dr. Nelson L. Adams, the immediate past president of the National Medical Association and a physician who operates a minority physician network and provider service network that serves more than 90,000 primarily minority Medicaid patients, said in a letter to Governor Jindal, “Medicaid Reform is needed to ensure that Medicaid funds remain available so that the neediest can receive the same quality of care that any citizen should expect.” Dr. Adams pointed out that in his provider service network, physicians are rewarded for health care improvements and the results have been significant for the population the network serves. He also stated that well-child checkup rates have improved from 40 percent under the old “fee for service” system to more than 70 percent - a rate substantially higher than that experienced in Louisiana.
The Council for a Better Louisiana said in a statement, “In Louisiana, we have talked about health care reform for a long time, but we’ve never really had a plan to work from. Now we do…At the very least, the new plan is a step into uncharted territory for Louisiana if for no other reason than the fact it’s the most comprehensive reform plan put on the table by any governor in memory…CABL believes we must take the plunge, get legislative approval to proceed, and submit the necessary waiver requests to the federal government to begin the effort of transforming health care delivery to the uninsured in Louisiana.”
In a letter to Levine, Tulane University President Scott Cowen said, “Louisiana has historically ranked worst in the nation and is long overdue for modernization. We support the broad concepts you have outlined in the Louisiana Health First concept paper and look forward to working with you and other key stakeholders on the details of design and implementation. We appreciate how inclusive and forthcoming the administration has been with details and documents related to the reform plans.”
When Louisiana Health First was created in August 2008, Levine appointed a diverse group of stakeholders to advise the Department on its development. Levine and executive staff have also met with countless stakeholder groups for their feedback and input. Among the groups represented are advocates, consumers, physicians, nurses, hospitals, social workers, insurers and pharmacists.
Louisiana Health First is a three-pronged approach that calls for (1) expanding access to affordable health insurance coverage statewide; (2) providing “medical homes” for Medicaid recipients through coordinated care networks (CCNs), which will offer consumers more choices on coverage and benefits, increase provider participation in CCN management and reward healthy outcomes for patients, and increase system transparency by making provider quality, satisfaction and efficiency performance measures available publicly; and (3) creating an Academic Medical Center to compete with America’s best teaching and research institutions.
For more information on Louisiana Health First, visit www.dhh.louisiana.gov