Ben Lockhart

SALT LAKE CITY, UT — A state Medicaid panel heard the downside of a strengthening economy Thursday when a home health care agency pleaded for funding changes in order to keep employees from taking higher-paying jobs.

Kevin Whatcott, owner of Homewatch Caregivers of Utah, said Medicaid reimbursement rates must be changed in order for the home care industry to keep up with rising costs.

“The Medicaid rates for personal care are not keeping pace with what is happening in the caregiver community,” he said.

The cost of labor for home care organizations has increased as rising wages in other industries have created heightened competition for employees, putting an acute financial squeeze on those medical providers, Whatcott said. The struggle to keep employees affects all levels of home care services.

“We’re dealing with a fragile population who without these services, might end up in a nursing home,” he said. “If they don’t get regular assistance, they decline.”

His plea was among several made to the state Medical Care Advisory Committee, a non-legislative body responsible for recommending budget priorities for Medicaid funds to the Utah Department of Health’s Division of Medicaid and Health Financing.

The division will present its conclusions to Gov. Gary Herbert later this year, and he will consider the information when creating the budget he recommends to state lawmakers.

Presenters asked for changes in Medicaid policies for several health services, including IUD contraceptives, telehealth, eyeglasses, laboratory testing, expensive drugs used for exceptionally rare diseases, home care, asthma education and more.

A few also chimed in that they would still like to see Utah expand Medicaid eligibility in order to help more people.

People with asthma

Brittany Guerra, health program manager for the Utah Asthma Program, touted the importance of her organization’s curriculum teaching young people how to cope with their breathing difficulties, particularly in rural Utah. Guerra cited the estimated $300 cost associated with three asthma education visits from her organization, compared to more than $12,000 in costs associated with an asthma-related hospitalization and more than $1,700 for a typical asthma-related emergency room visit.

“If we can (reach) people with asthma, they’re more likely to control their asthma,” ultimately making the organization’s education efforts an upstream health effort that saves money, Guerra said. She asked for Medicaid dollars to be made available to clients participating in the program.

Pricey drugs

Russ Elbel, Medicaid program director for Select Health, warned that one-of-a-kind, pricey drugs could demand more and more attention from the Medicaid program going forward.

“The pipeline of new drugs to treat these diseases is expanding every day,” Elbel said, warning that the state needs to keep those potential costs in mind when deciding Medicaid funding priorities.

Medicaid expansion

Jessie Mandle, who sits on Medical Care Advisory Committee, made a formal presentation for Voices for Utah’s Children asking for see Medicaid expanded in Utah. Mandle also would like to see increased outreach efforts to help Utah families check their eligibility for Medicaid and sign up if they are eligible.

“Especially in this time of so much health care uncertainty, it’s important families to know their options and get care,” Mandle said.

‘Very long process’

Emma Chacon, director of Medicaid operations in the Division of Medicaid and Health Financing and member of the advisory committee, reassured all of the presenters that their concerns and requests would be studied seriously.

“We do consider them meaningful (and they do) carry weight,” Chacon said. “This is the beginning of … a very long process.”

Chacon said the committee will meet twice more – on June 22 and July 10 – and take public comments about Medicaid spending before voting on which priorities to recommend.

Ultimately, the division recommends prioritized requests to the Centers for Medicare and Medicaid Services with the blessing of other state leaders, including Herbert, asking for adjustments to how Medicaid is used in the state. However, getting requests granted can take a while, Chacon told the Deseret News. Changes requested at this time in 2016 are still pending, she said.

In the nearly finished fiscal year 2017 – the latest period for which data was immediately available – federal Medicaid funds authorized in the state amounted to more than $1.85 billion.


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