Utah developing plan to tame Medicaid

"I think Sen. Liljenquist is going in the right direction by wanting to move on those opportunities for ACOs in Medicaid," she said. "But the other thing we really need to think about in Medicaid is payment and delivery system reform. … Aligning incentives in the way we pay providers — we should pay providers more if they manage care around a whole episode of care — that's the idea of ACOs. But there are other payment reforms and payment strategies that we can use that will go after wasteful spending in Medicaid. Now is the time to really look at those and use the ones that make sense for us."

Health care advocate Sheila Walsh-McDonald of the Salt Lake Community Action Program thinks changes to Medicaid ought to catalyze implementation of what she deems to be overdue and necessary reforms to health care in general.

"Cost-containment in health care costs and payment reform, it's much bigger than just Medicaid," Walsh-McDonald said. "We need to do it as a nation. It's a huge paradigm shift; we need to do things differently.

"The state is on the right track looking at payment reform not only for Medicaid, but they're looking at payment reform globally — for those with insurance and without insurance. We need to contain costs."

e-mail: jaskar@desnews.com