Docs want kids ad­dressed in Wash. Med­i­caid waiver

Modern Healthcare - - REGIONAL NEWS - —Vir­gil Dick­son

Some providers say a pro­posal to trans­form Washington state’s Med­i­caid pro­gram doesn’t take into ac­count the needs of chil­dren.

The state is seek­ing $3 bil­lion in fed­eral funds to over­haul its Med­i­caid pro­gram in a five-year pi­lot pro­ject. It seeks to have its man­aged Med­i­caid plans over­see both men­tal and phys­i­cal health ser­vices, as the two are now largely ad­dressed sep­a­rately.

The state also wants to change the way it pays for care. By 2019, it aims for 80% of its Med­i­caid care to be pur­chased through value-based pay­ment. It also wants to launch a De­liv­ery Sys­tem Re­form In­cen­tive Pay­ment pro­gram, which al­lows fed­eral Med­i­caid fund­ing to fi­nance in­cen­tives for providers to pur­sue de­liv­ery-sys­tem re­forms.

Providers say the waiver pro­posal doesn’t out­line how ex­actly it will reach all of its goals. Oth­ers ex­pressed con­cern that the waiver ap­pears to have no ini­tia­tives that ex­plic­itly tar­get chil­dren, who make up 45% of the state’s Med­i­caid pro­gram. “Given it’s such a large pop­u­la­tion of Med­i­caid that’s al­ready fac­ing sig­nif­i­cant gaps in care, this waiver could pose a sig­nif­i­cant op­por­tu­nity to change things,” said Dr. Mike Du­das, pres­i­dent of the Washington chap­ter of the Amer­i­can Academy of Pe­di­atrics.

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