Louisiana's Revamped Medicaid Program Will Likely Attract National Insurers Ahead of Reform-Related Medicaid Expansion

NASHVILLE, Tenn., May 26 /PRNewswire/ -- HealthLeaders-InterStudy, a leading provider of managed care market intelligence, reports that Louisiana is reforming its current fee-for-service Medicaid delivery model, adding coordinated care networks comprised of health plans, provider coalitions and hospitals. According to the recent Georgia, Alabama & Louisiana Health Plan Analysis, Medicaid insurers not currently operating in Louisiana such as AMERIGROUP and AmeriHealth Mercy will likely consider applying to become a designated coordinated care network.

As outlined by Louisiana's Department of Health, coordinated care networks can be structured as prepaid providers who are paid a capitated fee for an array of primary care services or as fee-for-service primary care case management groups that are eligible for additional payments when driving down costs. Under the plan, pharmacy benefits will be provided separately on a fee-for-service basis.

The coordinated care initiative replaces the state's previous Medicaid reform attempt, Louisiana Health First, which failed to win approval from the Centers for Medicare & Medicaid Services.

"Louisiana's new coordinated care delivery model for its Medicaid program emphasizes management and quality, and is expected to save the state money while improving health outcomes. It will also drive national Medicaid insurers to the state, as they prepare for major Medicaid expansion in 2014," said HealthLeaders-InterStudy Analyst Jan Shuxteau. "In Louisiana, the coordinated care delivery model is necessary to help control costs as Medicaid enrollment expands and we'll likely see other states take a similar path."

Other topics highlighted in the recent Georgia, Alabama & Louisiana Health Plan Analysis include:

• Value-based insurance designs are attracting employers in Georgia.
• Insurers are likely to see an uptick in demand for consumer-driven health plans paired with health savings accounts, but they may need to reshape those products to conform to the federal healthcare reform law and coming federal rules.

Why Pharmaceutical Company Managed Markets Teams Need Health Plan Analysis

Health Plan Analysis identifies key health plan trends, allowing pharmaceutical companies to create comprehensive strategic plans and sales strategies at state and local levels. Updated quarterly, Health Plan Analysis provides a detailed look at plan design and financials, as well as information about mergers, legislation and other influencers driving healthcare in a particular region.

About HealthLeaders-InterStudy

HealthLeaders-InterStudy, a Decision Resources, Inc. company, is the authoritative source for managed care data, analysis and news. For more information, please visit www.HL-ISY.com.

About Decision Resources, Inc.

Decision Resources, Inc. is a cohesive portfolio of companies that offers best-in-class, high-value information and insights on important sectors of the healthcare industry. Clients rely on this analysis and data to make informed decisions. Please visit Decision Resources, Inc. at www.DecisionResourcesInc.com.

All company, brand or product names contained in this document may be trademarks or registered trademarks of their respective holders.

SOURCE HealthLeaders-InterStudy

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