The prognosis for a multi-county health care plan became terminal Tuesday.
Crow Wing County Commissioners voted reluctantly to end their pursuit of a plan they said would have increased service and saved money. The previous checkups indicated good health, but the county's health care plan took a turn for the worse this month.
The health care plan proposal, called county-based purchasing, involved five area counties -- Crow Wing, Cass, Wadena, Morrison and Todd. In an April 14 letter to Crow Wing County, Kevin Goodno, Minnesota Department of Human Services commissioner, said he could not support the county's request.
In the late 1990s, Crow Wing County pioneered a county-based purchasing plan -- a purchasing system operated by a county or group of counties -- to provide a localized health care option for Medical Assistance and general assistance clients. The program, called the Essential Health Plan, involved contracts with area medical providers -- from pharmacists to major hospitals -- and allowed more choices than the state alternative. The plan had state support in 1999, but did not receive a needed federal waiver in early 2000 and Sluss said they ran out of money to pursue it.
Using a blazed trail, South Country Health Alliance, serving multiple counties in southern Minnesota, found success where Crow Wing County didn't, benefiting from Crow Wing County's experience. Partly because of Crow Wing County's involvement in that original effort, South Country Health Alliance was willing to look at a plan to serve the counties of central Minnesota.
In his letter, Goodno noted South Country Health Alliance's fine record in providing service. Goodno, appointed by Gov. Tim Pawlenty, said he encouraged the county to pursue a competitive strategy involving South Country Health Alliance, which would be supported by the state.
The sticking point for the state was the single managed care organization, or single source, providing service in the county. The county argued for a single source over a competitive environment because that choice was available from all willing medical service providers. Susan Beck, county human services director, said the financial viability of South Country Health Alliance's operations was questionable if they did not serve as a sole-source operation.
The counties have an option to appeal Goodno's decision. But the board listening to the appeal can only make recommendations to Goodno.
Beck said it is apparent the other managed health plans have a lot of influence with the state's Department of Human Services. Commissioner Terry Sluss said he was concerned about spending the full $108,600 the county put up for the process with the health alliance when the future seemed so doubtful.
Commissioner Ed Larsen said the state is saying it is not interested in what it claims to want -- getting more for less.
"I don't want to fight," Larsen said.
Commissioner Dewey Tautges said his problem with that feeling was not fighting for what you believe in. Tautges cast the sole vote against withdrawing from the South Country Health Alliance proposal.
"This is special-interest politics," Larsen said. "I know where the pressure is coming from -- it's the health plans."
The county board agreed to send a letter to the state voicing its opinion that it was being denied at a bureaucratic level.
RENEE RICHARDSON can be reached at firstname.lastname@example.org or 855-5852.
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