Conversations With Perry and Friends

Perry Cohen, Pharm.D.

In this episode of "Conversations with Perry and Friends," host Perry Cohen, Pharm.D., a longtime member of the Managed Healthcare Executive editorial advisory board, has a wide-ranging discussion with John Baackes, former CEO of the L.A. Health Plan, the largest publicly operated health plan in the country. It provides health insurance coverage to more than 2.6 million low-income residents of Los Angeles County.

Cohen and Baackes discuss the government's role in healthcare. Appproximately half of the U.S. population is dependent on government-funded health insurance, so if there going to be changes in the federal financing of health care, it's going to have a major impact, Baackes observes

People with Medicaid coverage face hurdles accessing health services, Baackes noted, a problem that he says can be traced back to low Medicaid payment rates.

John Baackes

"What we need is parity in the payments between Medicare and Medicaid, and that doesn't mean reduced Medicare [reimbursement]," Baackes says. "It means increased Medicaid [payments] to match Medicare, and you would have more providers participating. That would be step one in trying to correct that deficiency that's there for the Medicaid population."

Cohen and Baackes also discussed the advent of Medicaid managed care. Most states have contracted out the management of their Medicaid programs to not-for-profit and for-profit health plans.

"Managed care ushered in the era that we're now in, where we do data collection, we do outcome reporting, and we now pay providers for improvements in those quality outcomes," Baackes says. "I think managed care did give us the benefit of measurement and accountability that was lacking before. Does that mean it's perfect? Of course not. We're in a mess, but we have tools now that we did not have before as a result of managed care."