HHS has approved Alabama's application for a five-year Medicaid waiver, allowing the state to implement a Medi-caid reform plan that will move recipients into a managed-care network for their healthcare needs.
The state says its project is unique because the network will be a partnership between a private HMO and traditional public providers.
"By testing this public-private partnership, HCFA will be able to evaluate potential improvements to the Medi-caid program," said Bruce Vladeck, HCFA's administrator.
Alabama is the 16th state to receive a five-year waiver from the federal government to implement Medicaid managed-care systems (Nov. 11, p. 77).
The Alabama initiative will affect 69,918 Medicaid beneficiaries in Mobile County and represents $70 million a year in federal Medicaid dollars.
Starting March 1, 1997, Medicaid recipients in the county will be enrolled in the new BAY (Better Access for You) Health Plan. PrimeHealth Organization, a private HMO, will administer the plan, which is designed to cut costs while providing more preventive care.
The plan will provide all mandated Medicaid benefits without any copayments, deductibles or cost sharing. It will also expand the eligibility period for family planning services for low-income women from the current 60 days postpartum to 24 months.
Enrollees will be able to choose their own primary-care provider and may change providers within the network at any time. The network includes federally qualified health centers and the University of South Alabama hospitals and affiliated outpatient centers.