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

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Members of the <strong>Committee</strong>, my name is Patricia Riley and I am Vice
President of Government Programs for Medica Health Plans which is part of
Allina Health Systems. -Allina Health System is comprised of 17 hospitals,
600 employed physicians and a 1 million member health plan called Medica,
which contracts with over 7000 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 (PMAP). Our PMAP membership
includes AFDC and the elderly. Currently, Minnesota does not mandate the
disabled population to enroll in a managed care organization (MCO) however,
this is being developed as we speak.
Medica has participated in the Prepaid Medical Assistance program
since its inception in 1985. I have made available to the committee a copy of
an article which describes our <strong>Medicaid</strong> program and focuses on several of
our accomplishments to date. Program highlights include:
* A transportation program called Provide-A-Ride, which provides
90,000 cab or bus rides to doctors appointments each year.
* Welcome calls -- to explain health plan and determine need for
services.
* Multi-lingual staff -- staff-are fluent in Spanish, Russian, Chinese,
Hmong, and Vietnamese.
* Multi-lingual materials -- enrollment and communication materials
are printed in multiple languages.
* Social Service Coordinators -- problem solvers who connect
members to non-medical services.
These are just a few of the programs we have added since beginning
to work with low income and elderly populations ten years- ago. These
innovations are illustrative of the important value added features managed
care organizations must be willing to develop and invest in, in order to
adequately meet the needs of non-traditional managed care members. Each
of the above programs was designed to address barriers identified by our
members and our providers, to getting needed services. We quickly learned
that coverage does not equal access, and by merely enrolling the AFDC and
elderly populations into a managed care plan and expecting them to look and
behave like a commercial population is a big mistake indeed.