January 26, 2024
The Healthcare and Hospitals Policy Council
About the Council’s Work
The Healthcare and Hospitals Policy Council was established at the request of Governor-Elect Jeff Landry to identify the problems that exist in the Healthcare and Child Welfare space in Louisiana and to discuss and propose solutions to those problems. This council was led by Keith Myers and Allyson Pharr and included voices from all over the healthcare continuum in Louisiana. The findings listed below represent
the recommendations made by the council.
Improving Louisiana’s Health Outcomes
Louisiana continues to experience healthcare challenges as our state still ranks 50 th in overall health in the country. Our state faces the ever-present task of combatting a significant disease burden as well as barriers to healthcare access. Louisiana’s rural communities are disproportionately affected as these areas experience significant gaps in service offerings and lack of skilled professionals to treat them. We
must also confront the great need for more consistent mental health services all throughout the state.
Too many of our citizens lack adequate access to this level of care and continue to end up in emergency rooms or jails as a result. Another segment of our population, infants and expectant mothers, have experienced more setbacks over the last decade as Louisiana currently has an “F” rating for our preterm birth rate and ranks 47 th in maternal mortality. A lack of OBGYN services in underserved areas and
necessary prenatal care are major contributing factors and must be addressed.
Recommended Solutions
1. Continue efforts to address obesity, diabetes, and other comorbidities through health plan updates and increasing access to more cost-effective interventions. We need to explore ways to bring down the costs of newer pharmaceutical options and expand availability.
2. Identify more opportunities to partner with Primary Care Physicians and align incentives to prioritize preventive care and patient engagement.
3. Develop a comprehensive statewide master plan for behavioral health service delivery. Work with providers to expand mental health services and access to more outpatient treatments, resulting in shorter stay options both in urban and rural communities.
4. Study ways to increase ER diversion for mental health services and work with law enforcement agencies to access wrap around services for citizens in need.
5. Conduct a review of NICU bed availability across the state. Bring hospitals and community partners together to offer OBGYN services in rural areas. Explore improvements in technology to increase prenatal care.
6. Take steps to further align the education pipeline as a way to graduate more healthcare
professionals. Work to create more partnerships with our Community and Technical College System. Furthermore, we should take a comprehensive look at how to graduate and retain more physicians, while also expanding options for residency and fellowship programs.
Moving our Communities from Dependence to Independence
As we approach 2024, over 40% of Louisianans are enrolled in Medicaid benefits while another 18% participate in the Supplemental Nutritional Assistance Program. In these two major federal programs, administered and partially financed by the state, children make up the bulk of the beneficiaries. Navigating these multi-layered programs can lead to lapses in coverage and a lack of resources. The high number of enrollees are also rooted in ever-present poverty that is exacerbated by a skills gap and a
tepid economy.
This sets the stage for a conversation that needs to occur in Louisiana. We have to prioritize these challenges to increase opportunities for this vulnerable population. Only then can we provide an environment for our citizens to move beyond the reliance on social safety net services. We also see the effects that food insecurity causes all across the state. A severe lack in the availability and access of fresh foods and more nutritious options often leads citizens to eat what’s available versus what is more beneficial.
Recommended Solutions
1. Study ways to avoid a benefits cliff for citizens who are entering higher wage, skilled jobs in our workforce.
2. Evaluate programs that can boost healthy food options and access for Louisianans. Currently, thousands of Louisianans live in food deserts and experience daily food insecurity.
3. Explore ways to modernize and align the application and renewal process for Louisianans utilizing Medicaid, SNAP, and other public benefits. The multitude of systems and regulations surrounding these programs create greater costs to the state and can be burdensome to those most in need.
4. Create a new working group of state agencies and community partners to recommend
efficiencies and innovation among benefit programs. Increased data sharing and transparency between systems is a critical next step.
5. Partner with Managed Care Organizations and physicians to provide enhanced nutritional education for patients.
6. Explore ways to work alongside industries and create public-private partnerships to make continued investments in rural and impoverished communities.
Putting Patients First and Reducing Bureaucracy
Navigating the complex arena of healthcare is still a daunting task for patients. Most communities in our state do not have adequate access to healthcare services. At best, the waitlists are growing for patients to see a provider; at worst, there simply isn’t anyone to see them in a given area. Louisiana should prioritize policies that help our providers spend more time seeing patients rather than filling out paperwork and fighting insurance companies. Our communities are still struggling to stabilize and boost their healthcare workforce. Louisiana needs to get out of the business of saying no to innovation – we need physicians and nurses to take care of the generations to come, and we cannot do that if we can’t graduate, recruit and retain talent.
Recommended Solutions
1. Centralize credentialing for providers across Louisiana’s Managed Care Organizations. By creating a one stop shop, we can expedite the approval of physicians, allowing them to see patients from all Medicaid health plans.
2. Develop a framework to streamline pre-authorization criteria among health plans. Far too often, patients are denied access to necessary testing and screening, creating an adversarial relationship with a patient that could be avoided.
3. Reduce barriers to physician licensing in our state. In order to attract and retain quality talent in our healthcare workforce, it’s imperative to cut down on cumbersome paperwork and processing times.
Protecting Louisiana’s Children and Strengthening Families
Many children across Louisiana are still facing adverse situations in their family dynamic. One case of child neglect and abuse is one too many, however reports of these atrocities only continue to increase. Our state’s most vulnerable need refuge so they can get the support and care they need. Parents who are struggling to make ends meet need increased access to workforce training and career coaching.
Recommended Solutions
1. Increase community partnerships and outreach to address the deficit in foster home availability. As it stands today, Louisiana has around 4,100 children in foster care and only 1,600 foster homes are available. This strain on the system isn’t sustainable.
2. Conduct a review of the increase in reports regarding the abuse and neglect of Louisiana’s children. Identify ways to speed up intake of this important information and prioritize staffing to ensure we have the necessary caseworkers and child support specialists.
3. Modernize software and streamline systems that are critical to supporting child welfare.
4. Study ways to align workforce coaching and training with the LA Workforce Commission and Louisiana Economic Development. Cut down on barriers that force us to operate in silos where services are spread across multiple agencies and departments.