GAMC future still in question

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Facing a $7 billion budget deficit, it’s unclear what the future holds for about 13,000 Minnesotans relying on General Assistance Medical Care’s (GAMC) Coordinated Care Delivery System (CCD). The program covers hospitalization and other services for the state’s poorest adults who don’t qualify for federal aid.

Through he tried, Gov. Tim Pawlenty couldn’t completely eliminate GAMC.  The DFL-controlled legislature eventually found a compromise to save the program.  It created a system where hospitals that still wanted to take GAMC patients would opt in to a lump sum of state funding, instead of charging per procedure fees. These funds were nowhere near the operating costs of most hospitals administering GAMC.

Furthermore, 17 hospitals in the state, including some Mayo Health System hospitals, studied whether or not to opt in. Of the 17 that studied the program’s feasibility, only four opted in, and none were outside Hennepin County. This, despite GAMC patients living all over the state.

The only Minnesota hospitals still administering GAMC’s CCD program are North Memorial Medical Center of Robbinsdale, St. Paul’s Regions, Hennepin County Medical Center (HCMC) and the U of M’s Medical Center (Fairview). Of the four, only two are currently taking new GAMC applicants (HCMC and North Memorial). This may change in the next few months as state funding for hospitals is approved on an unprecedented quarterly basis, making the ability to predict the capacity for applicants that much harder to calculate.

New conservative leadership will likely try to shed more money from the health and human services budget. How these slashes will affect GAMC and Coordinated Care Delivery patients remains unclear.

Also complicating this issue is Minnesota’s early Medicaid opt-in possibility. Barring legal action that would keep him from taking office, presumed Governor-elect Mark Dayton will likely make good on his promise to opt Minnesota into the newly expanded Medicaid program. It would bring an additional $1.4 billion to Minnesota’s health budget. How much of that would go directly to the patients using GAMC is unknown, but it is thought that GAMC and the new programs created to absorb funding reductions would be phased out, with patients probably rolling into Medicaid.