Dr. Dora Anne Mills is leaving her longtime post as Maine’s public health director to help reform MaineCare, the state’s Medicaid health insurance program for low-income and disabled residents.

Mills has been director of the Maine Center for Disease Control and Prevention — previously the Bureau of Health — for more than 14 years, serving in the administrations of both independent Gov. Angus King and Democrat John Baldacci.

Mills, a pediatrician, has overseen statewide public health initiatives such as cutting smoking rates among teenagers, increasing cancer screening rates and reorganizing the state’s public health system.

She will step down at the end of this year and start her new job Jan. 4 as medical director for MaineCare.

“This opportunity arose, and it seemed like a really good fit,” Mills said. “It really takes my experience practicing medicine in rural Maine and my experience in public health and really puts the two together.”

MaineCare is the state’s largest health insurer, providing coverage to about 340,000 children and adults. It has an annual budget of about $2.26 billion. The federal government pays two-thirds of that cost, and the state pays the rest.

Like Medicaid programs in other states, MaineCare is facing strong pressure to cut costs. The incoming Legislature is sure to look at MaineCare cuts for potential savings, even as state officials move forward with long-term reforms that they hope will reduce costs and improve health care quality starting in 2012.

MaineCare is preparing to shift to a managed care system, in which two or three private organizations selected by the state would provide coverage through their own health care networks. The managed care organizations would have financial incentives to reduce costs and keep their members healthy, Mills said.

“We’re one of the last states to really convert Medicaid to managed care,” Mills said. “Many states are ahead of us, (and) what they’ve seen is a reduction in cost as well as an improvement in quality.”

Anthony Marple, director of the Office of MaineCare Services, said the state plans to seek proposals from private organizations in May and hopes to start the system for most MaineCare members in July 2012.

He said Mills, as MaineCare’s new medical director, will play a key role by making sure the managed care companies improve care and the wellness of their members as they bring costs down.

“Generally, the outcomes are better for the patients and the costs are lower,” Marple said. “The key to having this be successful is, you hold the managed care companies closely accountable to the quality measurements.”

Mills will help to create and monitor the quality measurements, and will work with the managed care companies to improve the health of MaineCare patients by cutting smoking rates and taking other public health initiatives.

“What we’ve done in public health, we can take the same strategies and the same lessons and apply them to MaineCare,” Mills said.

The shift to managed care is being watched closely by the medical community, as well as patient advocates, who want to make sure that the new system does not limit access to quality health care.

“It was somewhat inevitable that there would be a transition” to managed care, said Mitchell Stein, policy director with Consumers for Affordable Health Care. “If it’s going to be done, we just want to make sure it’s done correctly.”

Mills will be replaced as CDC director by Dr. Stephen Sears, Maine’s state epidemiologist. Sears will be the acting director, and the job will be filled on a permanent basis by the next commissioner of health and human services. Gov.-elect Paul LePage is expected to announce his choice for that Cabinet post soon.

As CDC director, Mills is not a political appointee. She said she did not change jobs because there will soon be a new governor and Republican-led Legislature. She said she is looking forward to working with the LePage administration and lawmakers in her role with MaineCare.

Mills was once active in Democratic politics and is part of a well-known family of Maine politicians and public servants. She is a sister of outgoing state Sen. Peter Mills, a Republican, and outgoing Attorney General Janet Mills, a Democrat.

 

Staff Writer John Richardson can be contacted at 791-6324 or at: jrichardson@pressherald.com

 

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