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

MS. CHRISTENSEN. Steve.
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STATEMENT OF STEPHEN A. SOMERS, PRESIDENT, CENTER
FOR HEALTH CARE STRATEGIES, INC.
Mr. SOMERS. Thank you, and good morning. I am Stephen
Somers, and for the Hill staffers among you, you have in Jane
Horvath and myself two former <strong>Senate</strong> staffers who are examples
of what your future might be like-you too may be able to testify
before a panel on managed care at the <strong>Senate</strong> <strong>Special</strong> <strong>Committee</strong>
on Aging. It is a real pleasure to be here.
It is an honor as well to be here with Bill Scanlon and Jane, because
they represent two of the supreme catalogers of what is going
on across the States with respect to <strong>Medicaid</strong> managed care. I turn
to the GAO and to the National Academy for State Health Policy
constantly for information about where particular States stand, so
I commend to your attention their materials.
It is always a Pleasure to be on a panel with officials from Wisconsin
and Maryland. I worked at the Robert Wood Johnson Foundation
for many years, and for health care philanthropy, Wisconsin
and Maryland are two States that are constantly seen as lighthouses
or beacons, which is to say leaders, in progressive model development
and innovation. It also means that they get all the grant
money, too, so I expect to be hearing more from Wisconsin and
Maryland in the future.
The Center for Health <strong>Care</strong> Strategies is a nonprofit organization
running two major programs for the Robert Wood Johnson Foundation
(RWJF) and also one for the Annie E. Casey Foundation.
There are two programs for RWJF. One is called the Building
Health Systems Program-actually, Wisconsin has gotten substantial
funding under that program from the Foundation-and the
<strong>Medicaid</strong> <strong>Managed</strong> <strong>Care</strong> Program. Both of them are focusing on
how to make health systems work better for people with chronic
health problems.
As you probably know, the Robert Wood Johnson Foundation is
a large health care philanthropy. It spends about $250 million a
year on demonstration projects training, evaluation and research
programs. A lot of them are large multi-site national programs.
The <strong>Medicaid</strong> <strong>Managed</strong> <strong>Care</strong> Program (MMCP) is just one of
them, and I am going to focus the remainder of my time upon that
program, which is described in your packet, and for which there is
a Request for Proposals (RFP) attached.
The program is a $21 million national program, the goal of which
is stated in your material, to make managed care work for <strong>Medicaid</strong>
recipients, especially those with chronic health conditions. I
would very much agree with what Peggy Bartels of Wisconsin said
about <strong>Medicaid</strong> managed care in particular having the opportunity
to lead the rest of the managed care market place with respect to
serving these populations. This is because the commercial plans
just have not served these populations before, and <strong>Medicaid</strong> has
the kinds of requirements and attention to quality issues that
should serve as a guide for all other managed care enterprises
serving disabled populations.
The objectives of the MMCP are to build capacity among the purchasers-principally
the States and, to some degree increasingly,