| Plan |
Jindal Louisiana Health First | |
| Date |
November 2008 | |
| Overall Approach |
Improve health outcomes and expand coverage through Medicaid reform | |
| Universal Coverage |
No | |
| Guaranteed Coverage |
Yes | |
| Portability |
Yes | |
| Voluntary Employer-Based System |
Yes | |
| New Programs |
Creating Coordinated Care Networks (CCN) that will consist of an integrated system of public and/or private primary care providers, specialty care groups, and hospital providers to provide a patient-centered medical home for each person eligible for Medicaid. | |
| Expansion of Existing Public Programs/Federal Law |
Statewide expansion of medicaid eligibility for parents and caretakers of medicaid-eligible children who live at or below 50 percent of the federal Poverty level
Expansion of Medicaid eligibility for all individuals living at or below 200 percent of the FPL in Region 5
Federal subsidy for individuals making over 200 percent and up to 350 percent of the FPL in Region 5 | |
| Insurance Pool |
N/A | |
| State Responsibility |
N/A | |
| Individual Mandate |
No | |
| Employer Mandate |
No | |
| Private Insurance Mandates |
Coordinated care networks will be at risk for the cost of fraud and will be required to aggressively pursue fraudulent activity
Coordinated care networks required to prove adequacy of their provider networks
Require strong provider participation in coordinated care network governance | |
| Individual Subsidies |
Allows eligible individuals to apply Medicaid premiums to their employer-sponsored plans, if such plans are available
Health care contributions for eligible individuals in Region 5 would be matched by federal dollars on a sliding scale based on income. | |
| Individual Vouchers |
Yes | |
| Employer Subsidies |
No | |
| Individual Plan/Provider Choice |
Yes | |
| National Health Board |
N/A | |
| Tax Changes |
No | |
| Premium/Co-Pay/Deductible |
Not addressed | |
| Health Quality Improvement |
Financial penalties for coordinated care networks failing to maintain an adequate network of physicians and other providers
Access and wait times for appointments closely monitored
Requires transition to the National Committee for Quality Assurance definition of a medical home and implement electronic health records
Allows for use of various managed care reimbursement principles such as pre-authorization, pay for performance, capitation, per member per month care management fees and shared savings
Requires reporting of data to assist quality improvement and evaluation and dissemination of performance data to the public to increase informed decision making
Coordinated care networks required to offer disease management and health literacy services | |
| Information Technology / Electronic Medical Records |
Requires coordinated care networks to help providers to implement electronic health records | |
| Individual Responsibility for Health and Lifestyle |
Yes | |
| Preventive care |
Engage consumers in healthy behaviors and responsible use of care by offering enhanced benefit dollars they can earn if they participate in their own care. | |
| Transparency |
Requires reporting of quality, satisfaction and efficiency data to the public on the coordinated care network's performance | |
| Drug Reimportation |
Not addressed | |
| Medicare Rx Drug Price Negotiation |
N/A | |
| Medical Personnel Education |
Proposes a community-based, not-for-profit governance model for a new academic medical center in New Orleans in conjunction with LSU and Tulane | |
| Mental Health Parity |
Not addressed | |
| Other Provisions |
Not addressed | |
| Cost |
$23.5 billion over 5 years | |
| Cost Containment |
Coordinated care networks will be at risk for the cost of fraud and will be required to aggressively pursue fraudulent activity | |
| Financing |
$492 million from FEMA for the destruction of Charity Hospital during Hurricane Katrina
Use of federal disproportionate share hospital payments primary care and outpatient services | |
| Source |
"Louisiana Health First Facts," Louisiana Department of Health and Hospitals, November 2008
"Louisiana Health First Health Care Transformation Concept White Paper," Louisiana Department of Health and Hospitals, November 2008
"CMS Federal Waiver," Louisiana Department of Health and Hospitals, December 2008 | |
