'MAC' means more for less Plan aims for better, cheaper care for poor.

December 09, 1991|By Sue Miller | Sue Miller,Evening Sun Staff

The state health secretary today announced the start of the "Maryland Access to Care" program, designed to save $24 million in Medicaid costs in the next fiscal year while improving the delivery of health-care services to the state's growing medical assistance population.

"Sixty-thousand patients already have voluntarily enrolled in the program," Secretary Nelson J. Sabatini said. "And within the next seven months we expect 75 percent or 320,000 Medicaid clients to sign up."

The program, called MAC, will demand "greater responsibility on the part of clients and more accountability from state and health-care providers," Sabatini said. The only other program like it in the country is in Kentucky, where it has been successful, he said.

"What we're saying is that we've got to find a way of moving [Medicaid] care up front so that we can improve the lives of poor people in the state," the secretary said.

A total of 1,500 doctors and nurse practitioners have agreed to offer personal continuing care for patients who in the past have gone to emergency rooms for expensive, non-emergency care. Participating physicians will receive an increase in fees in office visits from $21 to $32.

Under MAC, clients must choose a doctor or clinic as primary medical provider. The provider will keep patient records, provide primary and preventive care, maintain a 24-hour, seven-day call arrangement and refer patients to specialists if necessary.

Sabatini said he expects strong doctor-patient relationships to develop so there will be at least a 10 percent increase in childhood immunizations and another 10 percent increase in low-income women who begin to have Pap smears and mammograms on a regular basis. The state has unusually high levels of breast and cervical cancer.

The state will save money, Sabatini said, because Medical Assistance will shift resources toward primary and preventive care, discouraging "doctor-shopping" and non-urgent use of the emergency room.

When Medicaid clients sign up for the program, they receive new gold-and-black Medical Assistance cards. People new to the MAC program have 30 days to choose their own provider. If they fail to do so, MAC -- which has an office at the O'Conor Building at 201 W. Preston St. -- will make the choice for them, Sabatini said.

Medicaid recipients will be phased into MAC over the next six months.

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