Medicaid

Officials at eight Boston hospitals--including six Harvard teaching facilities--have called for Massachusetts to pay them premiums for some of their patients on Medicaid, a system similar to many corporate health insurance programs.

Hospital officials said yesterday they expect Governor Edward J. King to approve their proposal and that it will take effect by next July. If approved, Massachusetts would become the first state to run its own Medicaid program.

The program, designed to cut state Medicaid budgets gradually, is very similar to one that King originally proposed to help reduce costs, as mandated by Proposition 2 1/2 guidelines. The state budget is currently short $50 million in Medicaid funds and will probably require emergency funding by the year's end.

Like King's proposal--which he scrapped because of planning delays--the hospitals' plan would gradually replace the current system of direct state payment of every Medicaid bill.

As part of the cost-cutting package, the hospitals would limit hospital stays and step up the proportion of cases handled on an out-patient basis.

Hospital officials said their plan--which would first be implemented on an experimental basis with 27,000 Boston-area families--could become a model for lower-income health care throughout the nation. Only 15 percent of total Medicaid patients would be treated in the eight hospitals under the program.

The Conference of Boston Teaching Hospitals (COBTH), which is sponsoring the program, has received a grant from the private Commonwealth Foundation to draw up a formal implementation plan.

Dr. Jerome Grossman, chief author of the hospital proposal and director of the New England Medical Center, said yesterday the plan would "only postpone" fiscal pressures on the state, adding "programs such as Medicaid will be in for significant cuts in future years."