Medicaid reform means less duplicate tests

Medicaid reform means less duplicate tests

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by MIKE HANSON / NBC Charlotte

WCNC.com

Posted on June 23, 2014 at 6:18 PM

CHARLOTTE, N.C. -- Lawmakers in Raleigh are this week hammering out details for next year’s budget. One of the largest pieces is Medicaid, the safety net for people who cannot help themselves.
 
Medicaid is a $13 billion program in North Carolina that in recent years has run wildly over budget. The Governor and house republicans would like to see reforms in Medicaid that might save the state 3-percent.
 
Dr. John Baker is the Clinical Director for Community Care Partners of Greater Mecklenburg. Community Care of North Carolina is a non-profit that helps the state care for people on Medicaid. He says the big problem of Medicaid can be found in something as small as a test in an emergency room.
 
"So you have a person who comes in with chest pain. He has been coming into the ER for chest pain weekly for the last four years. They are known to every provider in the emergency department. Constantly having chest pain, constantly doing EKGs on them and the EKGs are normal," Baker says.
 
Medical personnel at Charlotte hospitals don't trust the old tests out of fear that this current ER visit may be the real deal.
 
Dr. Baker adds, "Even though, statistically speaking, the doctor has all the odds in his favor."
 
Baker is quick to point out that tests will still be done in a case like that, but instead of every week, tests would be done once a month. A small change like that would save Medicaid thousands of dollars a year.
 
"If you're practicing medicine intelligently you don't in fact get that EKG. That's easier said than done," Baker said.
 
CCNC believes that a comprehensive team approach to dealing with Medicaid patients provides better care, and is less expensive for taxpayers than it is to sit back and wait for Medicaid patients to show up at an emergency room.

Under reforms that CCNC would like to see implemented, a team of people would seek out the EKG-ER Medicaid patient to see what the real issue is, whether it is psychiatric, or some other physical condition. 
 
Lawmakers hope to have a budget deal worked out by early July.

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