Idaho's Medicaid Value program: different and better

When it comes to public policy, we all want what's best for Idaho. How can we do something better and faster, that saves taxpayers' money? We pride ourselves in taking the best part of programs that work well in other states and then create our own unique model.

In 2020, the Idaho legislature passed a bill directing the health care community to establish an innovative value-based Medicaid managed care program to provide quality health care for our most vulnerable citizens — it's called a Value Care Organization or VCO.

A VCO is an approach that emphasizes provider-led care focused on better patient health outcomes, better access to care, and can save the state money — without the cost or bureaucracy of inserting an insurance company.

The Legislature, however, is now considering a new Medicaid health care delivery model that would place a middleman between the patient and their doctor. And the middleman doesn't work for free. The proposed new model would give insurance companies a 15% administrative fee that would increase the cost of Medicaid or increase the losses your doctor, and other medical providers already take when seeing Medicaid patients.

Maintaining the VCO system not only ensures Medicaid patients receive the right care at the right time, but also encourages health care providers to focus on long-term wellness rather than just periodic or emergency care. By prioritizing value over volume or profits, VCOs can reduce unnecessary medical interventions, lower costs, and ultimately provide better care to those who need it most.

This concept also results in improved patient commitment, increased patient satisfaction, and holds the medical providers accountable for better health outcomes for our community. It's a win-win for everyone.

Although Idaho's VCO model has shown positive results in the first year, it needs to be given time to prove it can meet the Legislature's long-term goals of controlling costs, improving patient health, and maintaining an adequate system of health care providers around the state.

Idaho's Medicaid VCO program; It's different. It's better.