MANY health-care leaders across the Commonwealth of Pennsylvania are debating Governor Tom Corbett's proposed plan to change the state's current medical assistance program. Unless facts drive the debate, Pennsylvanians may face significant challenges in accessing quality health care.
Here are the facts: Our current medical assistance managed-care program - known as HealthChoices - is an indispensable cornerstone of our state's health-care system. HealthChoices, administered by managed-care organizations (MCOs), provides affordable, efficient care to hundreds of thousands of children, pregnant mothers, seniors and persons with disabilities. It has proven its worth in Pennsylvania by effectively delivering high-quality care to Pennsylvanians for nearly 20 years.
HealthChoices has saved the Commonwealth as much as $6 billion in a little more than a decade and is projected to save up to another $10 billion by 2020. According to the Lewin Group, a nationally recognized health-care policy and research organization, HealthChoices "continues to provide Medical Assistance cost savings to the state through a broad and innovative array of cost-containment strategies." MCOs operate the HealthChoices program in all 67 counties in Pennsylvania under contracts with the Department of Public Welfare.
Despite these findings, critics complain that beneficiaries and costs have continued to rise. So has the number of people living in poverty. The U.S. poverty rate increased markedly over the past decade due, in part, to two economic recessions. Pennsylvania experienced a significant rise in poverty since 2000, according to the U.S. Census Bureau. Yet, MCOs have stabilized government spending on Medical Assistance.
Presently, 2.3 million Pennsylvanians have access to broad-based hospital and health-care provider networks with HealthChoices. MCOs provide robust networks of medical providers, physicians, pharmacists and specialists. Also, these networks have the capacity to serve the Commonwealth's 500,000-plus newly eligible members under the Affordable Care Act, according to the Pennsylvania Coalition of Medical Assistance MCOs.
Pennsylvania's medical-assistance program offers value-added services. MCOs focus on prevention through coordinated disease management. This includes providing increased access for members, home-based care, vision and dental services, education, care management and monitoring of providers to ensure members receive quality health care.
HealthChoices promotes better health outcomes. Currently, recipients receive wide-ranging benefits in terms of access to health care, physical- and mental-health outcomes, and the financial stability of families. But, under the governor's proposed plan this may change.
Some say that medical assistance is a "welfare" program for urban Pennsylvanians. Yet, more than 65 percent of recipients live outside of Philadelphia and Allegheny counties. More than 27 percent live in rural communities where there is higher unemployment, greater barriers to access and higher rates of chronic illnesses than in urban areas. Nearly half of all medical assistance recipients are children. Additionally, children living with disabilities who have exhausted commercial coverage benefits are eligible for medical assistance regardless of their parents' income.
Our current medical-assistance program has proven its worth and is improving lives in Pennsylvania every day. Let's keep medical-assistance managed care working for Pennsylvanians.