Thursday, October 5, 2017

Mississippi True or Mississippi False Flag?

The Mississippi Hospital Association created Mississippi True to get Medicaid managed care contracts.  Such contracts are big business as three such contracts worth $2 billion were up for grabs this year . Mississippi True loves to play the homeboy card as it beats its chest and loudly proclaims that the Medicaid money should go to a Mississippi company.  There is just one problem: Mississippi True's flag actually belongs on foreign soil.


MHA has wanted a slice of the Medicaid business for several years.  Medicaid awarded two managed care contracts for the MississippiCan program in 2011.  MHA tried to get a piece of the action in 2014 when it tried to use the legislature as a legbreaker to collect some Medicaid vig.  MHA tried to get a $30 million tax credit. It also asked the the legislature to give the  Commissioner of Insurance the authority to weaken the requirements that other health insurance plans must meet if they want to operate in Mississippi.  No big deal unless the program crashes and doesn't have enough money to cover the losses.  However, the legislature said no but did allow the hospitals to create a "provider-sponsored health insurance plan" that could compete for Medicaid managed care contracts.  Such contracts are big business as Medicaid devours six billion dollars in Mississippi.  The MississippiCan contracts expired this year so MHA saw its chance to grab a piece of the $2 billion Medicaid managed care action.

MHA created Mississippi True, a non-profit company. It bid for one of the contracts but scored second to last out of seven proposals.  It is currently protesting the results and sued Medicaid last week to block the execution of the contracts. 

JJ obtained a copy of a presentation given by Mississippi True earlier this year that sheds more light on Mississippi True.   The "non-profit" claimed:

Mississippi True  aims to  provide  Mississippians access to  afford  able,  high-quality  health  care by  bringing  together  local  doctors,  hospitals  and  community  organizations  with  the  patients and families they serve.
Mississippi True brags about being "local":




Medicaid coordinated care mode ls are most sustainable when led by local, non-profit Coordinated
Care Organizations (CCO) with community history. In a local CCO,  ownership  and  leadership 
are homegrown, translating into more choices for patients and caregivers.
MHA says 60 Mississippi Hospitals created Mississippi True (See p.6 below for a list of participating hospitals.). The Board of Directors is populated by CEO's from hospitals around Mississippi (p.7).

However, the devil pops up in the details on page 9.  The actual staff who will operate Mississippi True are Evolent Health employees and have Evolent Health email addresses.   Evolent Health is based in Virginia.  The employees are:



Mark Rishnell: Interim CEO of MississippiTrue
Christie Spencer: COO of National Medicaid Center for Evolent Health
Lauren Morse: Senior Director of Evolent Health

Apparently, no one on the "team" is from Mississippi.  

Mississippi True's 990 is not available so it is not known what the company is paying Evolent Health nor what compensation is paid to Evolent Health employees.

Thus it appears what the Mississippi Hospital Association is doing is creating a local shell and outsourcing the entire operation to a Virginia company.

What is disingenuous is the MHA claim that this an attempt to keep Medicaid money from going out of state.  However, the heath care providers will not change regardless of who is approved with MississippiCan.  Patients use the same local doctors whether it is United, Molina, Centene, or yes, even Mississippi True.  United Healthcare is not sending patients to out of state doctors or parachuting doctors into Greenville and Tylertown.  The Medicaid patient sees a local doctor-period.  If the Mississippi patient needs to go to a hospital, he goes to a Mississippi hospital. Many of those hospitals are ironically owned by out-of-state companies.  We were for foreigners before we were against them. The Medicaid money is already spent and will be spent on Mississippi doctors and hospitals, regardless of who has these Medicaid contracts. Period. 



MHA is simply trying to get its hands on money spent to administer Medicaid managed care and any profit made by its non-profit company .  The problem for MHA is that is has no experience in operating such a program and is trying to play catch-up with its competitors. Enter Evolent Health. 

The Mississippi Hospital Association has every right to promote Mississippi True and get Medicaid contracts.  If the taxpayers can save money and patients get better healthcare, so be it.  However, Mississippi True and the Mississippi Hospital Association would like to have it both ways.  They want to claim Mississippi True is local while they take your money but send it out of state.



10 comments:

Anonymous said...

The SEC form D and amendment has additional details.

https://www.sec.gov/Archives/edgar/data/1688806/000168842917000001/xslFormDX01/primary_doc.xml

Anonymous said...

Lack of interest in these managed care / medicaid stories is sad!! People get worked up over a 200k deal at Department of Education but a $2 billion dollar contract at Department of Medicaid? Crickets.

Anonymous said...

I feel ya, 8:42. Billions in state money and nobody cares. Maybe they don't understand that a groups of hospitals wants to manage Medicaid money payable to...hospitals.

Anonymous said...

How dare you point out the facts?

Anonymous said...

If the hospitals bought David Dzelak a few more steaks they would get the contract.

Anonymous said...

Always interesting to see what a non profit like MHA pays it's highly paid employees.

Anonymous said...

Glad Medicaid did not bow down to MHA. Check the campaign finance reports of the legislators crying the loudest.

Anonymous said...

Evolent's out of state team is led by Mark Rishell who was fired during an "investigation by local and state investigators for mismanagement of Medicare plans". So MHA is lying about being a Mississippi company and importing fraudsters to corrupt our state. Maybe they could hire Chris Epps as a consultant under a work release program. Then, they would have a professional criminal to guide them. Notes to hospitals: when you lay with the dogs...

newsismybusiness.com/management-shakeup-at-mcs-julia-out

Anonymous said...

Money gets " laundered" through Mississippi " shell" companies all the time.
They take their cut and send the big money out of state.
But, y'all focus on the folks who haven't learned the fine arts of political gamesmanship well...yet.

Anonymous said...

So, public funds line the pockets of these three. And I’m sure they live very well. KF, keep up the good work and like a poster above said we get quiet when something like this surfaces. Could it be that there are too many people around here who don’t want their friends or family members brought into the light of this travesty?

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