This is disturbing, especially since I know that some of the health plans are creating real person-centered plans. I would like to see some level of commitment to PCP from the Health Plans, or there is going to be a problem. Apparently Jon Cotton thinks people with disabilities are boxes of cereal, and he should be able to put them on any shelf in his health supermarket he wants, maybe throwing away the ones that are too damaged? After all, aren't profit margins what we are really talking about here?....
Willie Brooks, CEO of the Oakland County Mental Health Authority, told me care is personalized to meet the needs of individuals in the system.
"When it comes to assisted living, something that works well with one person may not work well with another person," he said.
Jon Cotton, president and COO of Meridian Health Plan of Michigan, said he is in favor of person-centered planning. However, offering multitudes of non-standardized contracts would be costly. The state would have to create a Medicaid fee schedule for plans to pay individual providers.
“We won’t do onesy-twosy contracts,” said Cotton, noting the common practice where mental health agencies recruit specific direct care workers based on patient requests.
Even the National Committee on Quality Assurance, which ranks HMOs, has said there is a disconnect between individual care plans and a patient's goals, which is the heart of person-centered plans.
"The documented in-care plans commonly reflected necessary services or care, things like regular physician visits, medication management and patient education," NCQA said.
"The connection between the documented goals and the stated goals was sometimes obvious, but more often, it could only be explained by individuals or their care managers," NCQA said.
NCQA then asked: "How well can providers meet a person's needs if the care plan doesn't fully document what matters most to the person?"