Providers, HMOs Battle over Caring for Sick Medicaid Managed Care Infants

As many states have adopted Medicaid managed care rather than traditional Medicaid programs, care providers and parents of sick premature infants have come under new "pressures," including moving babies into cheaper care or discharging them once they are "deemed fit," the Wall Street Journal reports. The Journal highlights the case of preemie Deja Donegan, a Missouri Medicaid managed care patient who was born "critically ill" and 12 weeks premature. After spending nine months and 13 days in the neonatal intensive care unit of the St. Louis Children's Hospital and racking up medical expenses of $750,000, Deja went home with her mother. While Deja's case is considered medically successful, the Journal notes that what her case "says about the economics of Medicaid managed care is something else." Medicaid managed care systems have attempted to confront the "ambitious issue" of reducing "distressingly high infant mortality rates among African-Americans." While managed care has proved no "magic bullet" in solving cost and access problems for Missouri's Medicaid recipients, the system "has been beneficial to St. Louis' poor mothers in particular," according to Pam Victor, who oversees Medicaid HMOs for Missouri.

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