By: Health Insurance
Submitted: 2009-09-22 11:12:13 | Word Count: 637
As a physician legislator, I have the opportunity to scrutinize almost every program that Arizona funds. One of the largest is our state Medicaid program, AHCCCS. In the hospital, I treat many AHCCCS patients, but the more I learn about the program in the Legislature, the more impressed I am with it. Arizona may be sitting on the solution to our national health-reform debate.
Public-private partnership
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The Arizona Health Care Cost Containment System was created in the 1980s to serve as our state Medicaid program. The last state to establish such a program, Arizona used a new model that had not been previously attempted: managed care instead of fee-for-service.
This setup relies on a partnership between the state and private health plans. The health plans have a profit cap and voluntarily bid for contracts. The winning bidder receives a large guaranteed pool of patients.
AHCCCS-eligible patients get to choose an available health plan in their region and a primary-care provider. More than 80 percent of the primary-care doctors in Arizona are contracted. Prescription-drug coverage is broad and low-cost. Members can go to just about any hospital when needed. About 1.3 million Arizonans, 20 percent of our population, rely on AHCCCS for their health coverage.
Quality, efficiency
Unfortunately, some people assume care provided through AHCCCS is of low quality. That assumption is absolutely wrong. AHCCCS covers Arizonans with a remarkable degree of quality and efficiency. In fact, the benefit package for AHCCCS members is as good as or better than most private plans.
Furthermore, AHCCCS requires contracted health plans to focus on prevention, including weight management, immunizations, cancer screenings, blood pressure, cholesterol and diabetes checks. This keeps patients out of the hospital, saving money in the long run.
Most efficient in U.S.
The Kaiser Family Foundation recently ranked AHCCCS as the least expensive to operate of all 50 state Medicaid programs, citing the low cost per member per month. Combined with the impressive set of benefits AHCCCS provides, Arizona taxpayers get the most bang for their buck. Overhead costs are among the lowest in the nation at only 3.3 percent, and provider-reimbursement rates are surprisingly competitive.
We have in AHCCCS an efficient government program that provides excellent coverage to qualified families through a public-private partnership within a health-insurance exchange that has won national recognition for its success.
AHCCCS has been working well for the people of Arizona for more than two decades. This model for health-care delivery works. Health-reform proponents would be well served to closely examine AHCCCS and learn from its accomplishments.
Focus on the people
One of my patients recently shared his thoughts about health reform from his hospital bed saying, "It's time for the human family to come together and take care of itself." I appreciated the compassion and civility in his words as he assessed our ongoing efforts. If we truly are committed to resolving the problems facing our health system in a meaningful way, we will keep the focus on patients and people, and we will come to a solution. I suggest that we look to AHCCCS as a proven, efficient model for national health reform.
Rep. Matt Heinz, a Dem
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