Summary
There is perhaps no better example in the American healthcare system of the challenges associated with financing preventative and primary care than Medicaid. With lower reimbursement rates than Medicare and commercial insurance, and increasingly fragile state budgets, it’s challenging for state Medicaid agencies and Medicaid Managed Care Organizations to establish adequate primary and preventative care networks. In no small part because of these inadequate networks, Medicaid beneficiaries are high utilizers of emergency departments, which drives increased costs to the system and stretches precious state and federal dollars further.
Direct Primary Care, or DPC, is a promising solution to this problem, despite its usual association with up-market, concierge medicine practices; states like Michigan and Montana have kicked the tires on the concept. There’s also a bipartisan bill called the Medicaid Primary Care Improvement Act, which has passed the House last session and has bipartisan support in the Senate. To discuss the specifics of this bill and the practicalities of expanding the DPC model to government programs, I sat down with Health Policy Analyst Lawson Mansell from the Niskanen Center.
Check out the conversation below!
Connect & learn more
What we covered
00:00 Welcome and Introductions
01:05 Challenges in Primary Care and Medicaid
04:03 Understanding Direct Primary Care (DPC)
09:07 The Medicaid Primary Care Improvement Act
23:46 Addressing the Primary Care Shortage
28:34 Concluding Thoughts