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The Honolulu Advertiser
Updated at 3:38 p.m., Wednesday, January 21, 2009

State moves forward with managed care program for Medicaid patients

Advertiser Staff

The state will proceed with the planned start of a new managed healthcare program for Medicaid recipients on Feb. 1, though some doctors and medical service providers say they aren't going to participate.

Dr. Kenneth Fink, state Med-Quest Division Administrator, said nearly every hospital has contracted to provide the service through the program up from only two in early December. More than 2,000 physicians have signed up also to be providers.

"Implementation of the program is advancing very nicely," said Fink, speaking before the state Small Business Regulatory Review Board yesterday.

But others testifying before the board criticized the program and said they would not participate in it because they believed they would be paid less than they are now and must devote more time under the program to filling out paperwork to get paid.

"I won't participate in this," said Dr. Arlene Meyers, a Wahiawa pediatrician who said she will have to find other doctors to care for 20 handicapped patients.

The state is moving from a fee-for-service model to a managed-care model for 37,000 Medicaid clients who are either low-income elders, have permanent disabilities or are blind as it looks for ways to increase services and improve healthcare for the group.

The program — Quest Expanded Access or QeXA — also includes healthcare coordinators will lower costs by improving care and decreasing hospital and nursing-home admissions.