HHS says New Orleans-area health care reform proposal needs revising

A draft proposal from the Louisiana Health Care Design Collaborative on reforms for the New Orleans-area health care system requires some revisions to receive federal approval, a representative for HHS Secretary Mike Leavitt said on Thursday, the New Orleans Times-Picayune reports (Moller, New Orleans Times-Picayune, 9/29).

Leavitt and Louisiana Gov. Kathleen Blanco (D) in July signed a "charter" for the collaborative, a 40-member group of lawmakers, advocates and policy experts established to reform the operations and finances of the system.

The group plans to present a waiver application to Leavitt by Oct. 20 that will propose reforms to Medicare and Medicaid rules for beneficiaries in Orleans, Jefferson, St. Bernard and Plaquemines parishes and will seek to ensure that area residents have a "medical home," regardless of whether they have health insurance (Kaiser Daily Health Policy Report, 7/18).

Under the medical home provision, most area residents who receive public assistance would enroll in health care systems with primary care clinics linked with a group of specialists and hospitals.

The health care systems would have to use electronic health records, meet certain quality measures and meet other standards to qualify as a medical home.

Sonia Madison, a representative for Leavitt, said, "As it currently stands, there are several areas we're concerned about."

Madison said that the draft proposal does not adequately address disparities in the current system, in which most low-income area residents are directed to charity hospitals.

Leavitt also would prefer that the proposal include more public-private partnerships, Madison said.

According to the Times-Picayune, "Leavitt's blessing is critical to the overhaul plan because ... he oversees the Medicare and Medicaid programs that finance about half of all health care in Louisiana."

The collaborative and HHS officials plan to meet on Monday to discuss the proposal (New Orleans Times-Picayune, 9/29).