Contact: Maridith Geuder
As the state implements changes in the way it serves more than 720,000 Medicaid-eligible Mississippians, two Mississippi State social scientists will be helping evaluate the effectiveness of a new program designed to provide accessible, coordinated care.
Jeralynn Cossman, a medical sociologist at the university, and political economist Humphrey Costello are receiving more than $400,000 in external federal support to collaborate with the state Division of Medicaid in analyzing the new Mississippi Medicaid Medical Home.
The research will examine Mississippi variables such as provider and patient participation in the program, geographic variations in access and comparisons of disease burdens versus service availability. Quality measures will follow those established by the Agency for Healthcare Research and Quality's 2003 National Healthcare Quality Report.
By applying stringent objective measures, the scientists said they hope to answer a question vital to Mississippi's future: Does the state have the medical care resources needed to meet the needs of its population?
"Medical homes may be a viable alternative," Cossman said.
To be implemented in 2005, MMMH is part of the state's strategic five-year Medicaid plan that seeks to tailor programs to individual needs while containing costs.
"The Mississippi Medicaid Medical Home will identify a primary source of medical care and provide a coordinated approach to improved health and to disease management," said Francis X. Rullan, state Medicaid division spokesman.
Rullan said that, under the new program, Medicaid-eligible individuals will be offered a free physical examination to establish a health profile baseline. In addition, the medical home program will identify a primary care provider, expedite coordinated medical records and minimize unnecessary emergency room visits, he added.
To determine Medicaid eligibility, potential recipients will for the first time be required to have face-to-face interviews with a Medicaid counselor and to furnish proof of birth for children.
Rullan said the hoped-for outcomes include better, more affordable care. "With the implementation of annual face-to-face Medicaid eligibility determination, the Division of Medicaid anticipates a savings of millions of state general fund dollars through the elimination of ineligible participants," he explained.
Rullan also said the "implementation of the MMMH and the option of a free yearly physical will save more Medicaid dollars by eliminating unnecessary emergency room visits and diagnosing many medical problems before they become serious conditions."
During the five-year MSU project, Cossman and Costello will analyze Medicaid records to determine whether the program does improve access to and quality of care while controlling costs. Their research is conducted under the auspices of the Mississippi Health Policy Research Center, a part of the university's nationally recognized Social Science Research Center.
Cossman and Costello will start with an initial 60 million records to establish baseline data. Using a secure offline data laboratory, they'll track claims records before and after implementation of MMMH.
Mississippi Medicaid currently is entirely fee-for-service, with the state being assessed for each medical service or treatment the patient seeks. "Patients often are unaware of what they need and sometimes receive too much, or too little, treatment," Costello said.
Added Cossman: "The Mississippi Medicaid Medical Home approach is an attempt to take the best of managed care by coordinating physicians and providers and apply it to a fee-for-service system. As envisioned, it will make sure that Medicaid patients receive the right treatment at the right place."
In an earlier project funded by the Robert Wood Johnson Foundation and the state Medicaid division, Cossman studied changes in Medicaid reimbursement rates on access to care.
"That work will be an essential part of our baseline data," she said. "We know that nationally, only 60 percent of those needing medical attention receive the appropriate care."
NEWS EDITORS/DIRECTORS: For more information, contact Dr. Cossman or Mr. Costello at (662) 325-7127. Her e-mail address is Jeralynn Cossman; his, Humphrey Costello.