Wyoming lawmakers must decide early next year whether to continue funding a healthcare pilot program that supporters say could offer the state a cheaper alternative to Medicaid.
Wyo. pilot program for healthcare at crossroads
Wyoming's "Healthy Frontiers" program currently serves about 85 low-income people, mainly in Cheyenne and Casper. The state puts $500 into a health savings account for each participant to cover health expenses while capping the state's total exposure at $50,000 per participant.
Sen. Charles Scott, chairman of the Senate Labor, Health and Social Services Committee, has championed the "Healthy Frontiers" program. It emphasizes testing and preventive medicine and offers Wyoming its best chance at reining in soaring Medicaid costs, he said.
"We've got a choice to make," Scott said in a recent interview. "Are we just going to go along and do it the way we've always done it, and raise the taxes to pay for it, or are we going to try something different?"
Scott said he intends to introduce a bill in the legislative budget session that starts in mid-February seeking $24.3 million to expand the program up to 2,000 participants. He said that would allow the state to verify computer modeling that he said estimates savings on health care costs of up to 35%.
Wyoming's total Medicaid budget, including state and federal funds, for the two-year funding cycle that runs through next June is roughly $1 billion. Scott said it's likely the state's burden will increase substantially in years to come.
"Considering the financial problems that we've got in our Medicaid program, if we can save 35% on the traditional Medicaid population, that's well worthwhile," Scott said.
Gov. Matt Mead early this year signed a bill putting up $1 million to get the Healthy Frontiers program off the ground. But the budget proposal he submitted to legislators in early December doesn't call for any funding for the program for the two-year fiscal period that starts next July. Current funding expires at the end of June 2012.
"I think it's difficult," Mead said of Healthy Frontiers in a recent interview. "What we have seen is a fairly large amount of money being dedicated to that. We've had a limited number of participants so far show up. Some of them have already over-expended their health savings accounts. We have had some who have difficulty making the minimum payment to their health savings account."
The Legislature's Joint Appropriations Committee started hearings on state agency budgets in early December and will continue them in January. The committee chairmen have called on state agencies to prepare for possible cuts of up to 8% in the face of flat state revenue forecasts.
Sen. Michael Von Flatern, a member of the Senate Appropriations Committee, said he has supported Healthy Frontiers in the past but doesn't believe it has attracted enough participants.
Asked whether he would support Scott's proposal to put up $24.3 million to fund an expansion of the program, Von Flatern said, "Personally, I doubt it."
Wendy Curran, an executive with Blue Cross-Blue Shield of Wyoming, which administers the Health Frontiers program for the state, said current funding could accommodate up to 250 people. She said participation has been limited because so far it's offered only in Cheyenne, Casper, Lovell and Powell. She said the program receives many inquiries from people in other communities who would be interested if the program were available to them.
Curran said it's hard to tell whether the program is saving money. She said that when people first enroll, they generally have a lot of pent-up demand for healthcare services, so costs can spike initially.
Healthy Frontiers has been successful in getting participants to use generic drugs, Curran said. Most participants pay just over $9 a month to participate, the lowest possible rate based on their low incomes, she said.
The program covers all the cost of preventive care, including five physician visits, generic drugs and testing, Curran said. It covers up to 90% of other costs, such as hospitalizations and specialized care, she said.
Whenever health professionals and policy makers discuss how Wyoming might deliver health care differently, the discussion always includes elements of the Health Frontiers program, Curran said. She listed such things as focusing on preventive care, paying doctors for the time they spend keeping patients healthy and making patients financially responsible for their healthcare decisions.
"So simply based on that, and drawing the connection between things that people think have some value that are included in the Healthy Frontiers model, then I think it's probably worthwhile riding it on out a little farther," Curran said of the program.
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