Expanding Medicaid Managed Care

Jul 7, 2011

Come this fall, a large percentage of Kentucky's Medicaid patients will enter a managed care program.  Governor Steve Beshear hails the change as a major cost saver that ensures quality care The Governor says the statewide expansion of Medicaid managed care will save taxpayers more than a billion dollars over three years.   Beshear announced the state has awarded three contracts to firms which will manage the care given thousands of Medicaid recipients.

“Come October one, those three organizations will begin coordinating physical, mental, and dental care statewide for more than 560,000 medicaid recipients all across Kentucky,” said Beshear.

Managed care organization Passport already provides services to 170 thousand recipients in greater Louisville.  A state audit of Passport in 2010 blasted its management for over spending on meals, travel, and lobbyists.  Governor Beshear says the issue was addressed by a change in management, plus, he adds, proper patient care was never an issue.

Among the three new firms managing care will be Coventry Cares.  Company spokesman Ken Burdick says the savings will come through preventative medicine. 

“The list of services that are covered are determined by the commonwealth, specifically secretary Miller and her office. In all of our discussions there has been no reference to any intention today or in the future to reduce the scope of services provided,” added Burdick.

As a result of the state contracts, the three new firms are expected to hire 543 people, some 200 alone in Lexington. Health and Family Services cabinet secretary Janie Miller says medicaid patients will be enrolled with their current medical provider.  But, Miller adds, they also have a chance of switching to a different provider.  Medicaid patients will pay for their coverage on a monthly basis. 

Ann Joseph is a Medicaid recipient advocate with the organization ‘Covering Kentucky Kids and Families.  Joseph says the announcement contains a lot of good news, but adds the ‘devil is in the details.’.

“More needs to be known about how this will actually work and how they will be rolling it out in the next several months,” said Joseph.

Governor Beshear says the contract also allows for substantial state oversight of the Medicaid managed care expansion.  The plan must still be approved by federal regulators.