Health-care groups file records requests

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Under that plan, a third party would put together “managed care” networks of physicians, hospitals and other medical care providers. The idea is to improve patient health and reduce cost with better management of an individual’s care, called “managed care.”

The government would pay insurance premiums for Medicaid recipients, who primarily are children from low to moderate income households.

Salles and Spedale sit on a special technical advisory group that Levine appointed to give his agency advice on the health care restructuring project.

Spedale said Levine brought the group in “after decisions were made” on what type of restructuring plan the administration would advance.

“There’s not been a great deal of opportunity for input,” agreed Salles.

The lack of information has not helped, Salles said. “In the New Orleans area where hospitals have been struggling financially … the lack of certainty about everything leaves concern,” he said.

Levine said the panel was created to advise DHH as it developed an implementation plan. He said many ideas generated by the group will be included in the final document.

Spedale, Smith and Louisiana Hospital Association president John Matessino said they are more inclined to support a Medicaid revamp similar to one that’s been successful in North Carolina that does not move toward an insurance model.

Smith said a lot of the medical society’s opposition is rooted in not having “any real idea what the plan is.”

“From the information given, it’s a very top-heavy, ‘managed care’ assignment of patients that in the past has not worked very well in other states,” said Smith.

“We have to represent our doctors and their patients rather than the system and insurance companies,” he said.

Matessino and Spedale said the “managed care” model being discussed would take 8 percent or more of Medicaid funds away from health care for administrative costs.

“When all is said and done, how do you do that when there are no new Medicaid dollars put in the program? And, if the price of oil stays the way it is there will be less Medicaid money,” Matessino said.