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KSL Editorial: New Utah Medicaid law carries enormous potential

KSL Editorial: New Utah Medicaid law carries enormous potential

By Con Psarras | Posted - Apr. 17, 2011 at 9:30 a.m.

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SALT LAKE CITY -- One of the most significant and innovative pieces of legislation to come from Utah's Capitol Hill has been signed into law with relatively little fanfare, even though it was approved unanimously. It will have enormous impact in Utah, and is already getting a large amount national attention.

The measure would usher in an unprecedented and fundamental change to the way health care is administered and paid for under Medicaid. If it works the way its designer hopes, it will save Utah more than $700 million in the next seven years, it will create a better environment for doctors to treat Medicaid patients, it will improve the treatment they receive, and, in no small way it will become a model for Medicaid reform from coast to coast.

Ambitious as that sounds, there is reason to be optimistic it will all come true.

Utah Medicaid Law
The bill would do four basic things:
  • Prioritize managed care over fee-for services
  • Limit member and monthly growth
  • Establish evidence-based standards of care
  • Set up a Medicaid rainy-day fun

The bill rises from the labor of Sen. Dan Liljenquist of Bountiful, who has taken on the task of finding ways to prevent spiraling costs of entitlement programs like Medicaid from gobbling up obscene amounts of current and future budgets.

Under his reform package, health care providers will no longer simply prescribe treatment and wait for Medicaid to pay. Instead of a "fee-for-service" system, doctors and patients will be maneuvered into more of a managed care environment. Medicaid funds to individual providers and patients would be limited, but would be spent at the discretion of providers, who would have incentives to treat patients more economically, with an emphasis on preventative care.

The state's large private and public health care institutions are on board, as is the state's hospital association.

The federal government, which needs to grant a waiver for the law to take effect, is also said to be anxious to see how it works.

KSL believes it is an encouraging approach to an intractable problem, and, along with the state's recent efforts at immigration reform, is helping create a new breed of Utah export -- creative, common-sense solutions to serious national problems.


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