There are many provisions in Governor Walker’s current budget proposal that are getting a lot of media attention, and discussion amongst various interest groups.
But there are two “minor” proposals, that are getting almost no attention, but in fact could make major changes in the way Medicaid services are delivered for future recipients of any of the Medicaid programs, including institutional Medicaid for nursing homes, waiver programs, for people living a community or assisted living facilities, and even children, who may be receiving Badgercare or similar programs.
First, for over a decade, many of the Medicaid programs have been administered by “managed care organizations” which have been established here in Wisconsin as non-profit entities. These non-profit MCOs have a history of showing that they have operated quite effectively and efficiently at about a 3-4% administrative cost. The Governor’s proposal is to get rid of the non-profit organizations, and turn these same tasks over to for-profit, private companies. We don’t know yet what their fees or charges will be but looking at other for-profit organizations in the State, they tend to include a profit margin nearing 20 or 25%. In other words, many people speculate that this shift will actually increase the costs by about 20%.
The second “minor” change is the Governor’s proposal to run the entire State Medicaid system through one central office. The argument is that it will make the system more efficient.
However, just a few years ago, Medicaid was run on a County by County basis, and the State made a change so it ran through 8 regional entities called consortiums. If any readers are familiar with that change, I think it’s fair to say that the change from a County system to a regional system, has been problematic at best. Instead of being able to talk with a local caseworker, phone calls and letters are often lost in these regional consortiums. It’s hard to imagine that a State wide system is going to handle this more efficiently.
For people who are obtaining benefits under any of the programs administered by the Medicaid Agencies, these two “minor” changes could have huge impacts. To discuss how this may impact you, feel free to contact Attorney Grosskopf for an appointment to review your own situation.
Attorney Peter E. Grosskopf
1324 W. Clairemont Ave. Suite 10
Eau Claire, WI 54701