Contracting Out Medicare Management

We have written a few times in the past about the Federal government or states hiring contractors to manage Medicare billing and benefits. These contracts in some cases are to streamline billing and collections. Others are to actually manage the program. Texas has aggressively compared to other states outsourced management of state and Federal benefit programs to contractors, in one case ending up canceling the contract due to poor performance. Now fellow BNET Industry blogger, Ken Terry, writes that Texas ended a contract with Evercare to manage Medicaid in North Texas due to complaints of people not being able to get timely care due to a shortage of doctors and dentists. The company was actually being fined by Texas for these problems. The goal of the contract, like so many, was to actually save the state money through hopefully more efficient streamlining of care. Mr. Terry points out that a major issue facing Medicare in all states is that its payment to providers are less then private insurers making it less likely for them to accept these patients. The recently passed "Stimulus" or "Recovery" bill allows more people to be eligible for Medicaid who may experience this problem of finding a provider.