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Senate Medicaid Committee hears testimony on reform

JEFFERSON CITY, Mo. — The Senate Committee on Medicaid Transformation and Reform held another meeting in the Capitol today, where witnesses were largely comprised of hospital and healthcare administrators from across the state.

The hearings, which came on the same day as the House Working Group on Medicaid saw record crowds in St. Louis, mostly focused on how current healthcare practices could be streamlined and how the existing Medicaid structure could be reformed.

Sen. Gary Romine
Sen. Gary Romine

Senate Committee chairman Sen. Gary Romine, R-St. Francois County, has repeatedly echoed the position of Republicans in the Missouri legislature: that current healthcare practices must be reformed and streamlined before expanding Medicaid under the Affordable Care Act can be discussed.

Dr. Larry Lewis with the Missouri College of Emergency Physicians said that, nationally, less than 1 percent of the population accounted for more than 25 percent of healthcare costs, and that the compartmentalization of care exploded costs through repeat tests and unnecessary ER visits.

“You have a patient who for one reason or another is visiting several facilities, and those medical professionals in those facilities can’t see what he’s already had done,” Lewis said. He provided an example patient, “Gary,” who received at least five different tests a total of more than 25 times in a two-year period for various ailments. “If we can streamline the care for our highest risk healthcare consumers we can significantly reduce our costs across the board.”

Most testimony focused either on current law and how it can be modified to allow for cheaper healthcare coverage. Some witnesses cited that under current state law, doctors cannot refer a patient who enters the emergency room to a “Take Care” clinic — even if the patient does not have a serious medical condition — without being subject to a possible fine.

Others focused largely on the inability for healthcare providers to communicate with each other and the need for a more streamlined medical database, which would allow detailed records of patients to follow them across many healthcare providers.

Romine said the purpose of today’s hearings was to hear alternatives from those working in healthcare on how to reform Medicaid before expansion was considered.

The committee will meet again next month at a date to be determined.