Alabama Medicaid Looks for Alternatives to Regional Care Organizations


MONTGOMERY, Ala. (WKRG) – The Alabama Medicaid Agency is pursuing alternatives to regional care organizations after making the change less than three years ago.

Notice of the change in policy came from Governor Kay Ivey’s office who is supporting the decision.

“I support Medicaid’s shift in reform strategy, which has been fully shared with legislative leadership and other key stakeholders,” Gov. Ivey said in a press release. She added, “I spoke with Health and Human Services Secretary Tom Price, and he has assured me of the Trump administration’s desire to work with the states to allow more flexibility in Medicaid services moving forward.”

The Medicaid Agency is aborting the project because of the expected changes the Trump administration and Congress will make to Medicaid.

Regional care organizations, also known as RCOs, began in 2014 after the Alabama Legislature passed a bill in support of the program. According to the Medicaid website RCOs, “calls for the state to be divided into regions and for community and provider-led, regional organizations to coordinate the health care of Medicaid patients in each region, with networks ultimately bearing the risks of contracting with the state of Alabama to provide that care.”

Ivey says the state was at a crossroads and decided to pursue other options.

“The RCO model didn’t fail; instead the alternative is a recognition that the circumstances surrounding Medicaid have changed, thus our approach must change,” Gov. Ivey added.

Alabama since 2012 has been working to shift some of the state’s one million Medicaid patients to managed care provided by RCOs in the hopes of controlling costs.

The decision to move toward RCOs was supported by lawmakers in Montgomery to prevent the growth of Medicaid in the state. Former Gov. Bentley and lawmakers did not want to add federal money to the program.

State officials hope a change to RCOs will bring less risks for patients and provide the same results as the current program.

Gov. Ivey said, “Our end goal is clear – to increase the quality of services provided and protect the investment of Alabama taxpayers.”

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