8:33am

Wed September 21, 2011
Science/Health

Privatized Medicaid Begins in November

Kentucky Medicaid recipients preparing to switch to one of three private providers will have to wait another month to see the effects of the new privatized system. Earlier this year the state signed contracts with CoventryCares of Kentucky, Kentucky Spirit Health Plan and WellCare of Kentucky and then automatically enrolled Medicaid members with one of these providers. The managed-care approach to Medicaid is part of Gov. Steve Beshear’s budget-balancing plan and privatizing Medicaid will save the state $1.3 billion over the three-year contracts, said officials.

But not everyone is ready. Over the past couple months the Kentucky Hospital Association has voiced its concern for implementing a managed care system in such a short time. Hospitals are complex systems and some need more time to weigh the effects of signing on with any of the three Managed Care Organizations, said Neville Wise, acting Medicaid Services commissioner.

“They (KHA) expressed the need to review their contract and contract terms from the MCOs more thoroughly,” he said.

Kentucky’s Health and Family Services Cabinet has now extended the start date to switch to privatized care to Nov. 1. It was previously Oct. 1. Some hospitals still have to figure out who in their system will be on board with new rates under privatized care, said Wise.

“They’re very complex organizations and, as you can probably imagine, the contract terms between the MCO and an organization with that many mutli-specialties would take a little longer to review some of the terms and conditions,” he said.

HealthPoint Family Care is located in Covington and it has signed on with all three private Medicaid providers, said CEO Chris Goddard. Some of its patients have called and are concerned that they might not be covered if hospitals don’t sign up with all three private providers, he said.

The extra month should give the providers and hospitals more time to organize their networks, said Goddard.

Medicaid members are able to change providers until Oct. 5; and then again 90 days after the system is privatized.

Jefferson County and 15 surrounding counties will continue to be in contract with Passport Healthcare for another year.