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Show Senate Bill 228. Correctional Health Care Facilities Amendments (R. Montgomery). S.B. 228 requires all health care facilities within the Department of Corrections to be regulated and meet the requirements for accreditation by the National Commission for Correctional Health Care. Health care facilities within the Department of Corrections are exempt from licensure and regulation by the Department of Health. 1995 Interim Study Issues. The Health Policy Commission is directed by statute to consider the following during 1995: •Purchasing cooperatives •Special needs populations •Implementation and refinement of insurance reform •A rural health plan including a study of the impact of managed care on rural providers •Cost and quality monitoring process •Health care education reform to stress primary care. At its first meeting this year, the Health Policy Commission voted on the following issues: 1. To limit its study of insurance reform to cleaning up what had already passed and to monitoring the implementation of the reforms passed in the last two sessions 2. To limit its consideration of purchasing cooperatives to consideration of voluntary cooperatives 3. To include as a part of its study on medical education, the challenges for teaching hospitals, academic medicine, health provider education, and the state benefits from academic health centers The Legislature assigned the following issues to legislative committees for study during the 1995 interim: Business and Labor. The impact and appropriate role of nonprofit entities in competitive and industrial settings such as health care, the regulation of free standing, ambulatory, surgical centers, and the patient protection act. Human Services. Commitment of minors to mental health facilities and oversight of Medicaid expansion and Medicaid managed care. Health and Environment. Reports and proposed legislation from the Health Policy Commission, Medicare supplemental insurance reform, and optician and optometry licensing. Impact of Managed Health Care in Rural Utah Kathleen Hardy. Bureau of Primary Care and Rural Health Systems Division of Health Systems Improvement, Utah State Department of Health. Why Is the Impact of Managed Care in Rural Utah an Issue? Anecdotal evidence demonstrates that as managed care insurers move into Utah rural Gess than 100 people per square mile) and frontier (less than 6 people per square mile) areas, health care is becoming less geographically accessible for some residents. In these areas, the aims of trying to lower health care costs and trying to maintain accessible health care may conflict. The magnitude of the problem has not been adequately defined or quantified. Marketing affects availability of health care in rural/frontier areas. For example, some large employers contract, based on cost, with a statewide managed care insurer for all their employees. The contracted insurer may not always have a provider available in all areas employees could use. If local providers are not included in the company's managed care insurance plan, the employee cannot use them. Paradoxically, this situation could cost people living in areas un-served by a company's insurance plan more for less accessible health care. Three possible scenarios in mis situation are: (1) the rural/frontier resident may be required to pay the difference between what the health care insurance company will pay and what a local health care provider charges; (2) the rural/frontier resident may be required to pay the entire cost of the visit; or (3) the rural/frontier resident may be required to bypass the local provider entirely and travel, at a cost in transportation and time, to an approved provider in another city. Dr. Kim Bateman (practicing family physician and the IHC medical director for family practice hospitals) describes this issue as a question of whether Utah is going to use "...a cooperative model or a competitive model of care and insurance for the rural areas of the state?" There are pros and cons associated with both models. The competition model would foster lower prices and more efficient utilization. Under the competition model, some hospitals would be unable to compete with the hospital down the road. As a result, some small hospitals could conceivably close or may require large subsidies. On the other hand, the cooperation model would maintain or improve the viability of smaller hospitals and would maintain geographic access for their patients. Costs would stay the same or increase. 136 Communications |