State House panel seeks changes to aid insurers
A legislative committee is calling for changes to help sustain health insurance companies that manage care for Medicaid patients and last year suffered millions of dollars in losses.
Medicaid, known locally as MassHealth, is the government program that provides health coverage to 1.8 million low-income Massachusetts residents. About 42 percent of these people are members of six health insurers, known as Medicaid managed care plans.
A committee of legislators and health care executives assembled by House Speaker Robert A. DeLeo is set to issue a report Wednesday that asks state officials to alter enrollment rules so the insurers can count on a more stable membership. The report also suggests the insurers and state health officials share more information with each other to make sure reimbursement rates are as accurate as possible.
It also urges the health plans to adopt new payment models designed to rein in costs by reimbursing doctors more for keeping patients healthy instead of paying only for the number of services and procedures they perform.
The Medicaid health plans, which include Neighborhood Health Plan, Tufts Health Plan, Boston Medical Center HealthNet Plan, and three others, collectively lost $137 million in 2014 after they were swamped with new members who turned out to require more medical care than the plans expected.