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New Medicaid map puts Covington in southwest region

Covington County may soon be part of the eight-county southwest region for Medicaid services.

State Health Officer Don Williamson introduced the proposed map Monday, which is part of the state’s revamped Medicaid Agency that will soon provide health care to five managed care organizations throughout the state.

The system was mandated under a bill signed into law by Gov. Robert Bentley on May 17, and is intended to slow the growth of the cost of Medicaid, which receives about one-third of the state’s annual spending from the General Fund.

The Alabama Medicaid Agency will switch from a system of paying doctors and hospitals on a fee-for-service basis, and instead will contract with regional care organizations, RCOs, to provide care for Medicaid patients for a negotiated payment per beneficiary.

The RCOs will make money if they can provide care for less than the negotiated payment. That gives RCOs incentive to keep patients healthy through prevention and efforts to control chronic conditions, such as diabetes, Williamson has said.

The current plan calls for one RCO per region.

Medicaid beneficiaries in nursing homes will not initially be included in a regional care organization. Long-term care Medicaid programs, such as those providing care to people in nursing homes, continue unchanged through Sept. 30, 2016.

The regional centers are expected to be in place by Oct. 1, 2016, although some could begin operations sooner.

Williamson introduced the map Monday at a public meeting for health care providers, advocates and others.

Regions include a north region with 10 counties, including Madison County; a central/east region with 15 counties, including Jefferson and Shelby counties; a west region with 13 counties, including Tuscaloosa County; a central/southeast region with 21 counties, including Montgomery County; and a southwest region with eight counties, including Mobile and Baldwin counties.

The map will be subject to change during a public comment and rule-making process. Williamson said there would be at least one public hearing. The map is expected to be final by Oct. 1.

–Stephanie Nelson