S.L. doctor to play key role in Medicaid reform

A Utah doctor will play a prominent role in the national investigation and possible overhaul of Medicaid benefits during the next few years.

U.S. Health and Human Services Secretary Mike Leavitt last week announced a list of 13 voting and 15 nonvoting members of an advisory commission charged with identifying reforms necessary to stabilize and strengthen Medicaid. Dr. John C. Nelson, from Salt Lake City, will serve as a nonvoting member on the commission

"It's an honor to be with great-minded people on this commission," Nelson said. "I am humbled and concerned. I hope I have something to add."

Nelson is the immediate past president of the American Medical Association.

"Medicaid patients don't have a strong voice because they are so poor, so this commission is going to have to take it upon us to be their voice," Nelson said.

Nelson expressed concern about the makeup of the commission because he said few physicians were chosen. When he was practicing, he said, 40-45 percent of his patients were on Medicaid. As a nonvoting member, Nelson said he is not quite sure what his role will be but hopes his experience with Medicaid patients will be helpful.

Former Tennessee governor Don Sundquist will chair the commission and former Maine governor Angus King will serve as vice chairman.

The commission must submit a report to Leavitt by Sept. 1 that will outline recommendations for Medicaid on how to reduce its spending growth by $10 billion during the next five years. The report will also suggest ways to create long-term enhancements to better serve beneficiaries and consider possible performance goals for Medicaid.

"The goal is to find some way to save money," Nelson said. "We as physicians have some ideas on how to do that."

Nelson said preventative care and finding ways to improve quality would save money.

"We need to find the ways that are helpful to patients," Nelson said.

A second report by the commission is due Dec. 31, 2006, and will address ways to ensure the long-term sustainability of Medicaid.

Other commission members with Utah ties include Troy Justesen, deputy assistant secretary for the office of special education and rehabilitive services from the U.S. Department of Education, and Mark de Bruin, senior vice president of pharmacy services for Rite Aid Corp.

Justesen received a master's degree from Utah State University and began his career as an assistive technology coordinator for northern Utah at the Northern Utah Center for Independent Living in Logan. Early in his career, de Bruin served as chief executive officer and general manager of RXAMERICA, LLC, a pharmacy benefit management company in Salt Lake City.

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E-mail: nclemens@desnews.com