Central to the proposal is the premise that health care is too expensive across the entire system, driven in large part by shortages in primary-care services that make people delay care until their health worsens or seek emergency room treatment regardless of urgency.
The "Idaho Accountable Community Care Act" seeks to change that dynamic while addressing the longstanding issue of how to provide care to low-income Idahoans. It would provide a state-funded solution that preserves
It builds on earlier proposals to provide
With the Legislature scheduled to adjourn next week, action on the proposal is expected to come quickly.
State-funded to start
Though based initially on state funds, the proposal does not preclude seeking other funding sources, including federal money, and in fact authorizes state health officials to pursue potential federal waivers and funding, subject to legislative approval.
But the proposal seeks to go beyond the question of providing care for low-income residents, emphasizing in an outline document that Republican control in
"This is to try to improve primary care to everybody in
The main elements of plan:
Managed care for low-income residents: Create a "coordinated care" program to serve
The state would contract with organizations to provide care exclusively in each of up to seven state service areas, each overseen by its own governing board. Those organizations would assign care managers to work with individuals at moderate to high risk, helping them to develop personal health care improvement plans. Accountability measures would encourage members to make healthier choices and include penalties, such as premiums or co-pays, if members fail to take advantage of them.
Lower cost prescription drugs for participants would be procured through the federal 340B discounted drug program.
More doctors: "Substantially increase" the number of family residency slots in
Non-emergency care: Require hospitals to set up programs and procedures to redirect non-emergency patients to primary care providers instead of receiving expensive emergency room care.
"We want to hold the doctors or the hospitals responsible and accountable for the care they deliver,"
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