Medicaid Managed Care - U.S. Senate Special Committee on Aging

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Ms. CHRISTENSEN. I'm going to interrupt again. Hope Hegstrom
of our staff is here, and she is going to pass around some question
forms, and at the end we will gather them up and read questions
for our panelists today. Barbara, I think we did get some of your
materials here and copied on the table. We have been bringing in
materials, so check the table before you leave today and see if there
is anything that you have not picked up yet.
Patsy.
STATEMENT OF PATRICIA A. RILEY, VICE PRESIDENT OF GOV-
ERNMENT PROGRAMS, POLICY AND PLANNING, ALLINA
HEALTH SYSTEM, MEDICA HEALTH PLANS, MINNEAPOLIS,
M[N
Ms. RILEY. My name is Patsy Riley, and I am Vice President of
Government Programs for Medica Health Plans, which is part of
Allina Health System. Allina Health System is a not-for-profit, integrated
health delivery organization comprised of 17 hospitals,
600 employed physicians and a one million-member health plan
called Medica-every time I hear that "one million," it astounds
me, because there are only 4 million people in Minnesota, so when
you think about that-we contract with over 7,000 physicians and
hundreds of hospitals, nursing homes and other allied providers
throughout Minnesota.
Medica has over 160,000 Government enrollees, 80,000 of which
are enrolled in the Prepaid Medical Assistance Program, or PMAP,
which Susan mentioned earlier. I was one of the architects of that
program, and just a little bit of career advice: Be careful what you
design as a State employee, because if you have to run it as a private
sector individual, there are days when I wake up and ask,
"Who the hell designed this?" when I was one of the people who
did-so keep that in mind.
Our PMAP membership includes AFDC and the elderly, and currently,
Minnesota does not mandate the disabled population to enroll
in a managed care organization. However, as Susan mentioned
before, we did try that as a part of the PMAP demonstration
project 10 years ago, and it was not successful; and a lot of what
I am going to talk about today in terms of my comments will focus
on the lessons that I think we learned from that and some recommendations
for where I think we go from here.
Medica has participated in the Prepaid Medical Assistance Program
since its inception in 1985. I have made available to the <strong>Committee</strong>
a copy of an article which describes our <strong>Medicaid</strong> program
and focuses on several of our accomplishments to date, and some
of the highlights in that article talk about a transportation called
Provide-a-Ride. We are basically in the cab business, and Providea-Ride
provides 90,000 cab rides every year to doctor appointments,
dentist appointments, hospital visits and so on, for our <strong>Medicaid</strong>
members.
We also do welcome calls to explain the health plan and determine
need for services. We do a mini health assessment to find out
if they are pregnant, if they smoke, if they have HIV or whatever,
and then t to direct them to the necessary services.
We have hired multilingual staff who are fluent in Spanish, Russian,
Chinese, Hmong, and Vietnamese, representative of all the