Monday, October 31, 2011

State's Medicaid program will be handled by managed care companies starting tomorrow

Update, Nov. 1: Kentucky Voices for Health, a coalition of more than 250 health care organizations, individuals and advocates, released its views on the move to managed care, which they said must be as much about improving the quality of health care as it is about saving money. "We want Medicaid managed care to be a positive move for both the fiscal health of Kentucky and the health of Kentuckians, so we must continually strive to ensure that all who are eligible have access to high-quality, affordable, effective health care regardless of poverty status or disability," said Dr. Rev. Marian McClure Taylor, KVH board member and executive director of the Kentucky Council of Churches.

The transition must also run smoothly, said Jody Mitchell, KVH executive director. "Our priority is ensuring that the 540,000 Medicaid members affected continue to receive the best health care possible, without interruption." (Read more)

About 560,000 Kentuckians on Medicaid will have a new way of getting health care starting tomorrow when the state switches to managed care.

So far, 68 acute-care hospitals, including some out-of-state facilities, have signed on to at least one of three of the managed care organizations chosen earlier this year by the state to run the program, reports Beth Musgrave of the Lexington Herald-Leader. Excluding the Louisville area, which has long been and will continue to be served by the Passport managed-care organization, there are 96 acute-care hospitals in Kentucky.

"A significant number of hospitals have signed in the last couple of weeks, and we anticipate that these numbers will continue to grow," said Jill Midkiff, spokeswoman for the Cabinet for Health and Family Services. The state had delayed the switch to managed care, which had been scheduled to begin Oct. 1, by one month to give providers time to sign contracts.

Gov. Steve Beshear said today the federal Centers for Medicaid and Medicare Services have approved the transition. "We have worked hard to make the transition as seamless as possible, and I appreciate the collaborative efforts that allowed us to reach this goal under aggressive deadlines."

Switching to managed care has been Beshear's answer to overcoming a Medicaid budget deficit. The program will be run by four managed care companies, which will be paid a predetermined per-patient, per-month amount regardless of what care is needed. Because they won't be paid using a fee-for-service model — believed to be more costly — and will try to streamline care, Beshear (right, photo by H-L's Pablo Alcala) said the move will save $1.3 billion in the next three years.

Delaying the move by another month could have cost the state $9.2 million in savings, Musgrave reports. (Read more)

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