What would bring seven senators to the State House for a meeting of the Health and Human Services Oversight Committee especially on a day as beautiful as last Friday?
The reason we were there, although we are not members of the oversight committee, was to hear a presentation from Nick Toumpas, the Commissioner of HHS on the implementation of his departmentís plan for a Medicaid managed care system for New Hampshire.
Medicaid, not to be confused with Medicare, is a state by state program of health care and other services such as nursing home care for the indigent with costs shared with the federal government.
The new state budget assumes that we will have $16 million in savings from a greatly expanded managed care system for Medicaid beneficiaries. Currently Medicaid spending is about $1 billion per year or about 20 percent of all state expenditures.
There are about 160,000 beneficiaries and that number will grow by 50,000 additional beneficiaries when the Affordable Care Act goes fully into effect in 2014.
The numbers tell you that changing or adjusting the way we provide benefits is essential as Medicaid is a major budget item and the cost trend is rising too rapidly to be sustainable.
The commissionerís report is also important to those who receive Medicaid payments for the care they provide to beneficiaries. So, there was standing room only with some outside craning their necks through the hearing room doors to make sure they didnít miss a key phrase or comment.
Most listeners wore orange name badges indicating they are lobbyists. Among those represented were hospitals, community health centers, a managed care organization, an insurance company, and dentists along with advocates for mental health and developmentally disabled agencies.
The first priority of managed care is to improve the health of beneficiaries. That might mean more timely visits to primary care providers and better management for those who receive care from multiple caregivers to avoid hospital admissions and emergency room use. Doing better for the patient will help reduce costs, too.
New terms like "medical home" and "health home" give some definition of where managed care is going. Medical home is built on a team of primary care professionals that can address multiple health issues rather going through a series of often interrupted services.
The health home concept is for those with serious, complicated and complex illnesses. We will be hearing more and more about the benefits for patients and the reduced cost to government from the health home plan. Health care providers will work with patients to deal with all of the personís problems which could include mental, addictions, diet and a myriad of other possible issues.
Not treating this seriously ill group of individuals in a comprehensive way will see costs continue to rise and patients remain not fully treated and recovering. That just allows the problems for the individual to continue. A goal of managed care is to stem that pattern.
The department will be looking for a contractor to implement the new program. When the contract is signed it is anticipated it will be the largest contract in the stateís history. That is why you will see plenty of oversight and attention by legislators in the months ahead.
I heard Steve Taylor, our former agriculture commissioner, on WNTK radio last Thursday morning talking about the 62nd Cornish Fair. I believe I heard it correctly that Steve has been to 61 of the fairs.
While my granddaughters, Finley who is two and her sister Eleanor, four, have been living in New London only since the fall of 2009, we have had two trips to the Cornish Fair so we may be creating our own family fair-going tradition like Steve and hundreds of other families in the area. The granddaughters had a great time, especially with the discounts for the rides, but mother and grandfather also had a good time and we look forward to the fair next August.
On Saturday there was breakfast at Parlin Field to participate in the annual "fly in" which is always enjoyable. It seems we are all interested in aviation. And we also had time, with many other family and friends, to help Bob and Jeannette Fraser of Washington celebrate their 50th wedding anniversary.
When we arrived at the Finn Fun Day at the Newport Senior Center, the John Wirkilas were talking with Larry Johnson. Judy and I were introduced to Larry who lives in Baker City, OR but has deep roots in Newport and Lempster. His grandfather bought the farm I now live in back in 1912, the same year his father was born. He and his brother now own adjoining property.
Larry has a treasure trove of papers and photos of family and old homes including the farm which he plans to share with local historical societies. And most importantly for me, he has offered to stay in touch with me so I can learn more about my farm and its history.
Cornish Fair, Parlin Field Fly-In, Finn Fun Day and the Fraser wedding anniversary celebration made for a special and pleasant Saturday in August.
The best newspaper headline last week: "NH ranked best in the U.S. to raise children, fourth straight year." That ranking by the Annie E. Casey Foundation is one more reminder of how fortunate we are to live in the Granite State.
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