Imagine it’s 1995 and you’re a high school senior in one of the medium places amid a sea of struggling rural with a dream of leading a multi-billion dollar health care organization.
You can work hard in college, earning bachelor’s and master’s degrees, then tackling a doctorate in healthcare management at a prestigious university. Thence, over a couple of decades, you slug through a series of administrative positions, learning the realities of the modern health care system. You prove yourself adept at budgeting, at handling large staffs and contracts, at navigating government bureaucracies and, finally, you apply for a top job.
Or, you can become a small town lawyer with enough time on hand to teach courses at the local community college, then get elected to the legislature. After someone ahead in line gets, well, too friendly with an intern, you move up. Then, term limits before your nose, the accidental governor gives you a job leading a ten billion dollar a year health care organization with a paycheck twice the size of your boss.’
Welcome to Missouri.
Yes, the current Speaker Of The House, Todd Richardson (R – Poplar Bluff) becomes the new MO HealthNet director on November 1st, getting a salary of $225,000 per year despite having no experience in the health care industry (except marrying a doctor). “From his time in the House, I know that Speaker Richardson will continue to listen to the concerns of Missouri citizens and help modernize and transform a program that will help our state” Governor Mike Parson said in announcing the appointment.
Richardson said that over the next 60 days, he plans to travel the state and engage with certain stakeholders “with the goal of developing a comprehensive road map for Missouri HealthNet’s future. ”These stakeholders include the Missouri HealthNet staff, the program’s Medicaid partners, providers, lawmakers and “most importantly, beneficiaries,” Richardson said.
Note that word “beneficiaries.” In traditional Medicaid-speak those helped are called “patients.” Oh, it could be a slip of an untrained tongue. Or, the new director sees his job as working for those who get money from MO HealthNet – the doctors, pharmacies and (increasingly) health insurance companies.
For example, this August managed care companies (including Clayton’s Centene) split $178 million, for the month. The total Medicaid/MO HealthNet bill for this August was $840 million. By December I expect the monthly tab to be over $900 million. That’s not really bad when you remember that MO HealthNet cares for a million Missouri citizens, including 24,000+ in nursing facilities.
“Richardson said his focus is not going to be on expanding Medicaid eligibility but rather on how to work with the existing population to improve health outcomes and put the program on a path to financial stability.” [Columbia Missourian]
Financial stability = save money. Won’t happen.
Basically, Missouri’s Department of Social Services is the second voyage of the Titanic, with that ugly hole down the starboard side. As I’ve noted before, endless reorganization and scorched budgets mean all components divisions – including MO HealthNet – lack the staff, and, data processing and management support to do the job. Plus, morale among the staff doesn’t exist.
The system demands that most of those needing help access services via the Call Centers: in August they got the average wait time down to 26 minutes. To do that scores of the workers who ought to be processing applications and updating files get shifted to Call Center duty from 11:30 a.m. till after 1:00 p.m. Many months more workers quit than DSS can hire. Like I said, morale among the staff doesn’t exist.
A fresh example: a homeless man in northwest Missouri applies for Medicaid. Fine, they said. You need, on your own, to get to a doctor 60 miles away to be evaluated.
Into this maelstrom comes a Poplar Bluff lawyer mostly unemployed due to term limits. Success is guaranteed, right?
Glenn