Governor Discusses Ideas for Better Care, More Savings in Medicaid Program

Governor Brian Schweitzer today discussed ideas the Administration is considering to improve care and save taxpayer dollars in the State’s Medicaid program.

"Montana ranks among the six states with the highest provider reimbursement rates in the nation," said Governor Schweitzer. "Yet Montana is ranked second from the bottom in income. It is clear that we need to find ways to do more with less."

Care for Montanans in need is costing more than in other states.

* In Montana, it is costing us twice the national average to care for an elderly citizen on Medicaid, and more than $1,200 more per person overall than the national average.

* Montana has one of the highest provider payment rates in the nation, yet some of the lowest income levels. We pay our providers 33% higher than the national average.

Currently 71% of Montana Medicaid participants are already on managed care through the state’s Passport program, a primary care case management system. Montana has 369 separate private contracts with 1003 individual providers across the state, costing the state $5 million in management fees per biennium.

A five county pilot project could examine how increased coordination could help patients get more preventative care to prevent life-threatening and costly emergencies, coordinate infrastructure to reduce administrative costs and prevent duplicate tests and services, and allow the state to negotiate for discounted services.

Adjustments in the way the Medicaid program is run need to be made in the next few years. With the implementation of the Affordable Care Act, the required Medicaid expansion becomes an unfunded mandate after three years and states will have to pick up the tab. Montana will be hit particularly hard: an additional 55,000 citizens will be added to the already 101,000 Montanans that are currently using the program.