10:54am

Mon October 31, 2011
Science/Health

Kentucky Switches to Privatized Medicaid Care

Kentucky’s three new managed care operators, MCOs, say they’re ready for members to switch over to privatized Medicaid care this week.  The switch on Nov. 1 is expected to save the state around $375 million over the three year contracts while managing patient care more efficiently.

The change was previously scheduled for Oct. 1 but was delayed by the Kentucky Hospital Association, which said hospitals needed more time to get contracts in order. Some physicians are still considering contracts with the new MCOs.

“Most of the hospitals tell us when they’re negotiating with a managed care company it takes six, nine, even a year to get these contracts all worked out. And with what the state was trying to do it was a very aggressive time frame,” said Michael Rust, president of the Kentucky Hospital Association.

The MCOs have acknowledged there may be speed bumps, said Jodi Mitchell, executive director of the consumer advocacy group Kentucky Voices for Health.

“They said that they expect a few hiccups in the situation but they will be addressing those. Ideally it would run smoothly. It would not be a disruption in care and the services that the members are receiving–it will be a coordinated process,” said Mitchell.

Despite written correspondence from the MCOs to Medicaid members about the switch, some may have slipped through the cracks, said Mitchell. Members were assigned a new provider but had the opportunity to switch if they preferred. They will again have the opportunity to switch providers after the Nov. 1 change.

Doctors can access Medicaid patient information on site as well, which should help Medicaid patients who are confused about any changes to their care, she said.

While the switch to MCOs will ideally provide better management of patient care, the cost savings should be monitored to make sure it doesn’t come at the patient’s expense, said Mitchell.

Written into the contracts were 30 days of continuity of care, which allows Medicaid members to continue with pre-authorized treatment in the first month of the transition. After this time the individual MCOs will judge whether treatments should continue on a case by case basis, said Mitchell.

The change affects around 570,000 Medicaid members outside the Louisville region where Passport Health Plan already provides privatized Medicaid care to around 170,000 members.