Utah project seeks to reduce 'overuse of health care'

Dec 8 2009

News outlets report on a pilot project in Utah to reduce overuse of services and Medicaid cuts in Kansas.

The Utah project seeks to reduce "overuse of health care," which is partly related to the fee-for-service system of care. The Salt Lake Tribune reports: "As part of its 10-year effort to reform the health system, the Legislature in 2009 passed House Bill 165, directing the Office of Consumer Health Services to get providers and payers together to devise health care delivery and payment reform plans."

The project will change the pay system for doctors serving diabetics and pregnant women. "Doctors treating diabetics will be paid a monthly retainer fee, giving them the flexibility to innovate. If a patient would be better served by calling them at home to make sure they are taking their medications ... doctors can do that without worrying about whether the insurance company is going to pay. If a patient has problems -- say a diabetic ends up in the emergency room for a preventable complication -- the doctor's monthly retainer fee goes down. Additionally, doctors will be paid a 'mini' fee for service so they aren't discouraged from providing care" (Rosetta, 12/7).

The Kansas Health Institute: "Consumer advocates and others say it will only become harder for low-income Kansans to get medical services now that the state is cutting Medicaid payments by 10 percent. ... Physicians and hospital officials have long complained that Medicaid doesn't cover their costs. ... Gov. Mark Parkinson last month ordered the cuts in reimbursement rates to doctors, nursing homes and other providers as part of ongoing efforts to keep the state budget balanced. The state faced about $250 million in red ink and the state constitution requires a balanced budget. ... The cuts are expected to fall especially hard on children and mothers" (Ranney, 12/8).