Health Care
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Jeff McWaters position on Health Care
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Health Care reform is the signature issue of Jeff McWater’s State Senate campaign. He has spent his professional career facilitating cost-effective changes that provide more people better coverage using fewer government dollars. The company started by Jeff at his kitchen table now serves 1 out of every 45 Medicaid recipients nationwide (1.7 million members), handles 9.9 million physician visits by members each year and works with more than 126,500 physicians and other health care providers. You learn a few things when you help governments control Medicaid costs and extend coverage in 14 different states. Jeff is excited about bringing that expertise and entrepreneurial spirit to Richmond.
Medicaid in particular subsumes more of the Commonwealth’s budget every year and, if current policies continue, there is no end in sight. Change is not an option; it’s a mandate. But that change must be principled change based on the notion that doctors and patients should be the decision-makers when it comes to treatment, not the government. Moreover, reform must recognize the need for cost-containment and competitive bidding processes. There is a substantial amount of waste and inefficiency in the present system. Those dollars can be better spent extending health care to uninsured children without having to raise taxes in the process.
Jeff’s Medicaid reform plan is premised on the following principles:
1. Medicaid should be subject to a competitive bidding process. Even though Medicaid expenditures comprise more than 14% of the Commonwealth’s general fund budget, the management of the program (claims processing, etc.) has never been put out to competitive bid. No private sector organization would allow a program that expends more than $5.4 billion annually to escape the scrutiny and potential cost savings of a competitive bidding process.
2. The Medicaid population should be shifted into an organized system of care coordination and case management. Sixty percent of the Medicaid recipients in Virginia are in the TANAF (Temporary Aid to Needy Families) program and account for only 24% of the costs. These recipients are in a system of care coordination and case management. But the other 40% of the recipients, the aged, blind and disabled population, are not covered by any type of managed care program and account for 76% of the Medicaid costs. By shifting the entire Medicaid population toward an organized system of care coordination and case management, Virginia can contain the costs of Medicaid and ensure that those with the greatest needs obtain the benefits of an organized care system with case managers and patient advocates helping to coordinate their care.
3. Use cost savings within the program to expand coverage for needy children. Presently, Virginia has approximately 187,000 children without any form of health insurance. The double tragedy is that more than 100,000 of them are eligible for Medicaid but not enrolled. With the savings from the first two parts of this plan, the Commonwealth could ensure that all of those who qualify are enrolled in Medicaid and can also begin to extend coverage to the additional 87,000 children whose families cannot provide insurance. With this three-part plan, the Commonwealth should be able to provide access to an organized system of health care for every child under age eighteen and at the same time control the expansion of runaway Medicaid costs.