Lansing, Mich. — State Senator Patrick Colbeck’s, R-Canton, proposed Direct Primary Care Services (DPCS) Medicaid Pilot, which would allow for an increase in the quality of health care for state Medicaid enrollees while reducing overall health care costs, endured a severe hit on Wednesday.
The Michigan Legislature passed a general omnibus bill, House Bill 5294, that greatly dilutes the framework and vision of the DPCS Medicaid Pilot.
This directly follows the action taken on Tuesday by members of the HB 5274 conference committee, who were selected to reconcile the Senate and House versions of the Fiscal Year 2017 Department of Health and Human Services budget, to pass a budget that included an incomplete version of the Pilot.
The HB 5274 conference committee included Reps. Rob VerHeulen, Earl Poleski, and Harvey Santana, and Sens. Jim Marleau, Peter MacGregor, and Curtis Hertel. All members of the conference committee voted in support of the conference committee report.
“It is very disappointing to learn that our state may have missed a golden opportunity to improve the quality of health care services, while reducing the costs levied on taxpayers,” said Sen. Colbeck, R-Canton.
The DPCS health care model would eliminate government and insurance company interference between a doctor and patient for primary care services. Sen. Colbeck said that if this primary care model was fully deployed to all state Medicaid enrollees, the state could save up to $3.5 billion per year from the $17.5 billion annual Medicaid budget. These savings would be a direct result of the improved health of enrollees.
As outlined by Sen. Colbeck in the Senate version of the DHHS Budget, which the Senate passed on May 17, the Pilot would require DHHS to enroll 2,400 Michigan Medicaid recipients in Direct Primary Care Services. Participants in the Pilot would still be covered by “wraparound” insurance for all services not specific to primary care.
The success of the Pilot would be evaluated on the basis of the resulting reduction in both the number and dollar amount of claims. These claims measurements would also be used as an indicator of improved health outcomes for patients.
However, in the modified House Version of the DHHS budget that was adopted by the conference committee the Pilot is no longer required, giving the department the option to implement the Pilot. Additionally, the prescriptive implementation guidelines in the Senate version were replaced by general guidelines that are insufficient to ensure Pilot success.
“I have great concern that the version approved by the conference committee, which was included in the general omnibus bill, does not provide the framework necessary to effectively implement a DPCS Medicaid Pilot. Despite this setback, I will continue to work to advocate health care solutions that would benefit all citizens of our great state,” said Sen. Colbeck.
The State budget now goes on to the governor for approval.