MINNESOTA
JANUARY 2017
PHYSICIAN
THE INDEPENDENT MEDICAL BUSINESS JOURNAL
Volume XXX, No. 10
Family medical accounts A potential solution to Minnesota Medicaid problems BY ROBERT W. GEIST, MD
T
he Minnesota Medicaid program has problems. Its costs have risen inexorably and patients may not be able to find a personal doctor they want. Instead these patients often seek care in hospital emergency rooms, which is not an ideal way to access health care.
Pharmacogenomics Understanding precision medicine
A new snag arose for some 300,000 Medicaid families in December 2016 when the Medica HMO announced that it would not bid at the next auction to service Medicaid families because low state capitation rate fees would ruin their business. This means that after May 1, 2017, one-third of the Medicaid population must choose another HMO. Is this really a choice? What if the folks enrolled in Medicaid could choose something other than an HMO for their care— perhaps an opportunity that enabled them to handle their own health care dollars and choose their own doctor? What if the state of Minnesota simply decided to pay people’s Medicaid bills? Connecticut has already tried this and reduced its Medicaid overhead costs by more than 50 percent. Family medical accounts to page 184
BY WILLIAM S. OETTING, PHD, AND PAMALA A. JACOBSON, PHARMD
W
hat if a patient’s response to an SSRI was known before prescribing and efficacy could be maximized? What if we could predict who will not achieve sufficient analgesic with pain medications? What if we could accurately predict if someone is at higher risk of a severe cutaneous reaction to phenytoin or allopurinol? A goal of pharmacogenomics is to answer these types of questions. Precision medicine is the field of disease diagnosis, treatment, and prevention that takes into account individual variability in environment, lifestyle, and genetic sequence. Pharmacogenomics (also known as pharmacogenetics) is the science of determining how genetic variation affects a person’s Pharmacogenomics to page 164