Sound off: Insurance companies profit at the expense of Hoosiers | Opinion

Insurance companies benefit at the expense of Hoosiers

Since December 2020, at the height of the pandemic, we have been appalled by the Family and Social Services Administration’s surprise decision to transition to a funded-only, insurance-focused managed care model by 2024.

An insurance-only managed care model is a more expensive and complicated system, a huge administrative burden that negatively impacts the level of care provided to residents, as hundreds of millions of dollars are diverted from the system to pay management fees of managed care companies.

The long-term care industry approach – SB 407 – requires the FSSA to implement a better model of reform that providers and other community organizations fully support: accountable care organizations and primary care cases.

The ACO and PCCM models have seen significant success in states such as Alabama, Arkansas, Georgia, Washington, and Oregon and are a preferred alternative described in a recent study by the nation’s leading Medicaid consulting firm, ATI Advisories. These proven models maintain the relationship between a patient and their doctor without insurance companies being intermediaries and allow local health care providers, community organizations and other stakeholders to be directly involved in the care of the resident. . The ACO and PCCM entities can accomplish this at the local level in Indiana and should be the way forward to reform Medicaid long-term services and supports.

Please visit www.WeCareLongTerm.com for more information on these issues and to learn more about what we believe the future of our industry should look like for how we provide the highest quality of service at Hoosiers.

In healthcare, nothing is more important than the relationship between doctor and patient. We are privileged to serve people aged 83 on average. We serve members of the greatest generation. Placing an insurance company between these elderly Hoosier and his doctor achieves very little, causing uncertainty, frustration and confusion at a time when they should be enjoying the reminder of their lives.

Our Hoosier elders have earned the right and respect to enjoy the reminder of their lives free from uncertainty, frustration and confusion.

Michael Bryant,

Administrative director,

Trilogy Health Services

Kristan F. Talley