Legislation is a slow process. It works differently than private enterprise and can be frustrating. Tonight, I was able to attend a Town Hall meeting hosted by Senator Kevin Cook. The theme of the meeting was managed care in Idaho and what does that look like. There were frustrations as well as reasons to be hopeful. But mostly, I walked away with a need to protect my profession so that we can serve those who need us. We know that OT works, but we need others to know that too.
Idaho is looking at establishing a Managed Care Organization for Medicaid in the State. This follows the trends of the industry and other states. What does that mean for you as an OTP in Idaho? It means that our health care system is not sustainable without changes. That means managing cost so that businesses are around to provide services. Traditional fee-for-service may be going by the wayside in exchange for managed systems where a patient is seen by an organization that manages care with the goal of containing costs and increasing outcomes. This means that some sort of entity is making decisions on where health care dollars should go and there are many providers out there, OTPs included, that will be fighting for a piece of the pie or a place at the decision making table.
There are some positives here. In an industry that is looking at value-based care, OT is well-suited to provide those outcomes. But we need to have a voice and help decision makers know our value. Occupational therapy is adaptable, and it is crazy to think that we can provide care in the same way without considering industry change. One of our emerging practice areas, primary care, was heavily discussed tonight. Numbers back up the fact that primary care is effective in containing health care costs by promoting health. We can be there on that front line to make a difference. Community based care, and other ways for us to use Medicaid dollars wisely, are needed. We need our creative out-of-the-box thinking to survive and thrive.
I also came away with a respect for this senator and others like him that are truly trying to make a difference. They are responsible for a large number of people that need health care, people that cannot always care for themselves. And these legislators want to do the right thing. They also need to know what the right thing is. That is why we need to have a voice.
Senator Kevin Cook is looking for feed-back. His contact info is firstname.lastname@example.org. gov. Please consider writing with your concerns about managed care in the State of Idaho.
By Lisa Baxter Hong, IOTA Legislative and Advocacy Chair