COLUMBIA, S.C. (AP) — Proposals aimed at improving residents' health particularly in rural areas of South Carolina were part of more than $75 million in Medicaid money included in a spending plan advanced by the House budget-writing committee Thursday.
South Carolina Republicans contend the state needs to focus on making people healthier, at a reduced cost, and not simply add people to an already-bloated Medicaid system. They have repeatedly refused Democrats' efforts to expand Medicaid eligibility under the federal health care reform act.
The $6.3 billion spending proposal approved by the committee for state taxes, now moving to the House floor, instead contains what Ways and Means Chairman Brian White called a Medicaid overhaul.
"It's about changing habits and making South Carolinians healthier," said White, R-Anderson. "We need to get better outcomes. At the end of the day, we're trying to get more with our dollars."
Democratic Rep. Harry Ott said he applauds the efficiency effort, but wants it done in conjunction with providing insurance to hundreds of thousands of additional people.
"All those things need to be done," said Ott, D-St. Matthews. "But in no way is it an alternative to Medicaid expansion. It's fixing a problem in the delivery system."
The plan follows ideas advocated by Medicaid director Tony Keck and focuses on rural areas his agency has mapped out as hot spots of poor health. It includes:
—Reimbursing 18 rural hospitals 100 percent of their costs for treating patients without health care. Keck touts it as a way to shift $20 million annually to hospitals that have a much higher share of patients who can't pay and are much sicker.
—Expanding access to specialists in rural areas with incentives for doctors to practice there.
—Expanding the telemedicine network, in which specialists can diagnose patients and consult with local staff around-the-clock from afar. Currently, 17 hospitals are in the network, but only four of them are in rural areas.
"Telemedicine has the potential to be transformative," said Rep. Kris Crawford, R-Florence, an emergency room doctor.
The plan also seeks to move treatment of the uninsured away from expensive hospital emergency room visits to qualified health clinics that provide free services. It puts an additional $10 million toward the clinics and free prescription drugs.