Change leaves care of disabled patients on Medicaid to trio of managed care companies

For the second time in two years, the state Department of Health and Human Resources is under fire for plans to change how it handles the care of tens of thousands of vulnerable West Virginians.

Critics worry the agency is in a rush to turn over the care of a group of 57,000 elderly or disabled Medicaid patients to three health insurance companies.

The critics question whether DHHR has carefully thought out the plan. And they wonder if the companies are experienced enough to deal with the vulnerable population they are about to be handed.

Beginning in December, the state will gradually begin moving patients who receive Supplemental Security Income into managed care. Managed care, like a private sector HMO, attempts to coordinate health care while controlling costs.

The three companies - Carelink, The Health Plan and Unicare - already manage care for 170,000 Medicaid recipients. Medicaid is the state and federal health insurance program for low-income people.

But SSI recipients have a different and more expensive set of medical needs than the normal welfare population. To qualify for SSI, a person must be aged, blind or disabled, a category that includes people with serious mental disorders.

"This is our most fragile population and probably also our most costly population," said DHHR spokesman John Law.

That means managing their care could be more challenging than for other patients.

There are basically two reasons to put people into managed care.

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Health care move panned