Medicaid consultant
Published February 14, 2014
by Scott Mooneyham, Capitol Press Association, printed in Greenville Daily Reflector, Feburary 13, 2014.
That the North Carolina Department of Health and Human Services has hired a “turnaround” consultant to help sort out its Medicaid operations does not say good things about where things currently stand within the state agency.
Obviously, where things stand in the future will show if the move proved to be a smart one. There are reasons to be skeptical. The News & Observer of Raleigh reported last week that the state’s health agency had awarded a $3 million contract to DC-area consulting firm Alvarez & Marsal.
It is a sole source contract, meaning the company was picked without any formal bidding process.
According to the newspaper story, the consulting firm will help the agency with all aspects of the Medicaid program: contracting, setting Medicaid rates, auditing, budgeting, and managing information technology and privacy concerns.A nine-person team will come into the agency to help fix the problems.
The most obvious, and well-publicized, of those problem has been the new Medicaid computer claims processing system, NC TRACKS, that has left doctors and other health care providers frustrated and outraged about delays receiving payments.
A memo obtained by the newspaper, addressed to State Budget Director Art Pope, said qualified staff members in the Medicaid division have been consumed with NC TRACKS and that it does not have enough remaining experienced staff to deal with other problems.
“The department has not been successful in recruiting experienced and qualified staff to alleviate this problem,” the memo said. Democratic state Rep. Verla Insko of Chapel Hill, a retired health care administrator, said she has been told that the division is littered with vacancies.
The important question for the consulting firm is will it be bringing in the kind of expertise, people who actually know and understand Medicaid and state government, needed to put the division on a path toward smoother and efficient operation.
Alvarez and Marsal’s primary experience involves righting private-sector firms that have found themselves upside down.
A state agency, though, is not a private-sector business.
Unlike former client Lehman Brothers, Alvarez and Marsal won’t be advising the agency on any Chapter 11 bankruptcy reorganization.
And unlike at HealthSouth, the state won’t be selling off assets to help balance the books.
Making things right will ultimately involve putting qualified, experienced government workers in the right positions, with the right systems, and the right work environment to get the job done.
A turnaround consultant might be able to help put that in place.
What it cannot do is the actual job that a reasonably well-run government agency does.
And if it fails to put something in place that improves the program’s operations, the McCrory administration will be answering questions about why it was unable to take steps on its own to put qualified workers in key government jobs.
February 14, 2014 at 7:02 pm
Norm Kelly says:
Well, isn't this interesting. The program that was created under DemocRAT authority, while the Demons controlled Raliegh, was finally rolled out under the Republicans, doesn't do the job it's supposed to do. Sounds an awful lot like Obamascare, but that's for another post.
Let's start with the definition of an oxymoron. Notice that the word 'moron' is in there. As it's defined in this editorial: 'What it cannot do is the actual job that a reasonably well-run government agency does'. The scary part is this editorialist thinks there is such a thing as a reasonably well-run government agency. Kinda like the other editorialist who claimed there were such things as ghosts: moderate/conservative Demoncrats. Both are so hard to find it might be easier to find an innocent person in Sodom.
This may not be the best company to turn around DHHS. It may not have been appropriate to award a no-bid contract. Once again a number of parallels to Obamascare can be drawn, but I'll pass for now. Except to wonder how this editorialist reacted to the billion dollar no-bid to create the failed website to go along with the failed law.
Perhaps instead of DHHS running the Medicaid reimbursement system it should be awarded to a private sector business in it's entirety. There should only be government agency oversight, but the day-to-day jobs should be done by private contractors. Who actually can be held accountable and fired when/if they screw up. Not like public sector employees who are either promoted or moved to another agency when they screw up. Or as happens too often in government organizations, the screw up is completely ignored. How many times does an IBM employee screw up with millions of dollars before that person is let go? How many times has a Northern Telecom employee screwed up on a millions-of-dollars contract and not been penalized? Perhaps NT isn't a good example since the company generally screwed up and lost it's shirt, terminated thousands of employees, all because management screwed up and refused to read the tea leaves in the bottom of every one of their cups.
So, you see, even using Northern Telecom as a bad example, they turn out to be a good example. Public sector jobs/employees who screw up take early retirement or get 'paid administrative leave' while under investigation. Northern basically closed up shop for screwing up. No comparison possible between private and public sector response.
It was more than likely a bad idea for the Republican administration to implement the DemocRAT-led replacement for Medicaid billing stuff without doing MAJOR, EXTENSIVE testing, but they did it. If I were a Republican who took charge after the Demons had contracted for certain computer work to be done, it's for sure I wouldn't implement it until I knew competent people had done the proper testing; provably done the proper testing. I'm not talking about Obamascare type of testing. I'm talking about real testing. I would not trust the DemocRAT contractor to have done it right, just like the Democrat people wouldn't have trusted the Republican-awarded contractor to have gotten it right either. Common sense. Something that's missing in politics.
