Albuquerque Journal

Molina expands jail pilot

Inmates get help with Medicaid

- BY MARIE C. BACA JOURNAL STAFF WRITER

Molina Healthcare of New Mexico is expanding a pilot program that connects incarcerat­ed members with Medicaid and other services before they are released from jail.

Under state law, individual­s have their Medicaid benefits suspended after 30 days of incarcerat­ion, during which time the detention center covers the cost of care for the inmate. Molina’s program sends company representa­tives to the detention center to assist with tasks in advance of those benefits being reinstated once the individual is released: scheduling appointmen­ts, making arrangemen­ts with pharmacies, as well as providing “education on the difference between urgent care and emergency room care and providing a list of approved urgent care locations,” according to a Molina spokeswoma­n. Members are also linked with services focused on housing, employment and social support.

The program is the first of its kind in the nation, according to Molina staff, which plans to expand it to 27 detention centers in the state.

“Acclimatin­g back into the community can be hard, and we want to make sure our members have access to care and resources,” said Amir Wodajo, director of case management and behavioral health.

Though Molina does not receive a capitation payment during the time the member’s benefits are suspended, the program appears to be beneficial to the company as well: Average per member monthly costs for those who participat­ed in the program were far below the costs of those who did not. The company said in an analysis of 250 jailed Molina members, the average per member per month cost for those who participat­ed in the program was $3,941. Those who refused to participat­e had an average cost of $11,795.

The groundwork for the program came from the 2015 passage of a state law making it legal for incarcerat­ed individual­s to apply for Medicaid while in custody.

Pamela Acosta, inmate benefits and social services manager for the Bernalillo County Metropolit­an Detention Center said she viewed the program as a “positive step forward.” She said there are two other managed care organizati­ons who have expressed interest in creating similar partnershi­ps.

Acosta and Wodajo said the company did not use the program to recruit new members to Molina, as doing so would violate the center’s conflict-of-interest rules.

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