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About 40 persons employed in the health-care industry in Niagara and Erie counties came together Tuesday to discuss upcoming changes in the state's Medicaid demonstration plan, which is intended to enroll 2.4 million state residents in managed health care plans beginning next Wednesday. However, those with some handle on what has already been taking place said there should not be a problem when the rest of the two counties' Medicaid recipients get on the bandwagon.

The staff of the Health Care Financing Administration was seeking comments from people affected by the plan during a readiness review. The administration is part of the U.S. Department of Health & Human Services, and Tuesday's meeting took place at the Best Western Lockport Inn.

"In this area they've done it a lot longer than the other areas of the state, so they're ready," said Donna Scocco-Mazzeo, a Medicaid specialist for the state Department of Health. She added that Niagara County officials seemed more ready to accept the change than those in Albany were.

Although Niagara County is not new in getting Medicaid recipients to enroll in a health maintenance organization, one man said it will not be an easy switch. "This is going to be a very complex program when you start to bring in an additional 2.4 million people into a program," said Alan J. Saperstein, regional administrator of the HCFA.

"We've been transitioning quite a few years," said Vincent J. DeAntonis, director of managed care at the Erie County Medical Center. He also said that quite a few Medicaid recipients in Erie County still have not switched to HMOs. "To be quite honest with you, on the fiscal side we're going to struggle with this."

One woman also showed reservations about the mandated switch. "We're hesitant about the rates we're being paid from the state," said Shirley Fohl, a manager at Independent Health. Ms. Fohl also said she wanted to protect the relationships the company already has with its doctors and patients.

Only one woman who is a recipient of an HMO associated with Medicaid was present and spoke at the meeting. She said she enjoyed switching to Independent Health Medisource from traditional Medicaid. "There were physicians I knew, trusted, had a relationship with."

The switch to HMOs will not cost Medicaid recipients any co-payments for doctors' visits or prescriptions, said Mary E. Villella, who supervises managed care for Niagara County. People on Medicaid currently have four HMOs to choose from: Fidelis Better Health Plan, Community Blue Community Care, Independent Health Medisource and Partners Health Plan, she said.

In 1992, Niagara County offered Independent Health Medisource to recipients, in 1993 it offered Community Blue Community Care as well as Fidelis, and in 1997 it began to offer Partners Health Plan, said Burt J. Marshall, director of Social Services for Niagara County.

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