By Bill Britt
Alabama Political Reporter
MONTGOMERY— “People need to understand and accept that we have the most value-oriented, cost-effective, minimal entitlement program in the country.” These are the words of Stanley K. Hammack, chief executive officer of University of South Alabama Health Systems referring to Alabama’s Medicaid program.
“We’ve got the most stringent eligibility requirements of any state in the nation when it comes to Medicaid,” Hammack a veteran administrator recently said. “There is not this vast number of people out there receiving Medicaid benefits. It is those vulnerable groups: children, expectant mothers, the aged, blind and disabled. And basically, the aged, blind and disabled are two-thirds of the expenditures.”
Everyday in the media people are bombarded with the idea that government spending is out of control and that a vast number of Americans are leaching on systems like Medicaid.
According to Hammack, this is not the case in Alabama, “In Alabama we have the least number of people enrolled and we spend the least on them. So, we are basically doing the minimum standards of what is required by Medicaid.”
This message has been spoken by Governor Bentley, Public Health Officer Dr. Don Williamson and countless others, yet, Medicaid in Alabama is still painted by some as this gross entitlement program.
“The providers [of Medicaid] are not overpaid in fact they are underpaid,” says Hammack. “Several of the providers, specifically hospitals, are covering their own way or at least a big portion of it.”
He also points out that Alabama is the only state that provides zero funding for hospitals as a part of Medicaid.
Like UAB in the middle of the state USA provide medical education in the state’s Southern region.
“UAB and USA are both designed to be academic health centers and educational entities. Any negative impact [on the healthcare delivery system] starts impacting the training of manpower and healthcare workforce development, specifically physicians, allied health professionals and nursing,” Hammack said.
Like other medical institutions “when you start losing money and you start having to cut programs you start losing some of these programs that are unique to UAB and USA and maybe a couple of hospitals in the state. If they are compromised to the point where funding-wise you can’t have them, then you have to start sending patients outside the state.”
The workforce component also has the potential of being compromised as funding is cut or eliminated.
“It starts being a cascade event that as the smaller hospitals drop out of providing for certain groups of patients or giving certain care that delivery starts going back to a larger hospital and then all the way back to where it is at USA and UAB,” said Hammack. “There is already a struggle to keep the higher cost programs as funds deplete, it begins creating a catastrophe–one built on the other.”
But Hammack says that the questions about Medicaid is Alabama are not discussed in the proper light.
“Alabama has probably got the best value of Medicaid, from the sense of dollars spent and what you get out of it, and the least expansion of entitlement in the country,” says Hammack. “The best way to frame where we are, we are already at the floor of where everybody wants to be.”
Hammack says that states around the country are looking for ways to rein in spending on Medicaid and that Alabama has already done what other states want to accomplish.
“Alabama has not expanded Medicaid and other states have. So, what you get into is that now all of the other states are trying to get to where Alabama is,” said Hammack. “We are actually the target where everybody else is trying to get to.”
Hammack says he believes Alabama is doing “the minimum that can be done and have any kind of program where you are attending to aged, blind, disabled and children population.”
He says he thinks we are “delivering value and we are not overdoing it on the Medicaid entitlement.”
