Kentucky Medicaid commissioner says managed care is improving health

Written by Jessie Halladay

The Courier-Journal

Jun. 13, 2013 

FRANKFORT — Medicaid Commissioner Lawrence Kissner told a legislative committee Thursday that he’s pleased with the way managed care is working for Medicaid patients in Kentucky.

Members of the Program Review and Investigations Committee met Thursday morning, hearing from Kissner on the status of Medicaid managed care after its first year of implementation. Kissner also briefed the committee on the expected benefits of expanding Medicaid, which Gov. Steve Beshear has said will happen in Kentucky starting Jan. 1.

“We are driving significant improvement in healthcare outcomes,” Kissner said of using managed care to deliver Medicaid.

For example, he said Coventry Cares, one of the managed care companies, saw diabetes testing increase from 6 to 59 percent. That same company showed access to primary care doctors increased for children age 12- to 24-months went from 39 to 97.6 percent.

Kissner also acknowledged that there have been some stumbles in the implementation of managed care.

He asked for an external audit of how the managed care companies have handled the appeal and grievance process. The audit found that two companies, Kentucky Spirit and Coventry, were deficient in their handling of cases, including not responding as quickly as required.

Both companies have been given improvement plans and are working to address the problems, Kissner said. After the meeting, Kissner said he believes many of the problems occurred in the early months of implementation and that improvements have already begun.

Some members of the committee continued to express their concerns about whether managed care, and the pending Medicaid expansion, is the right approach for Kentucky.

Sen. Tom Buford, R-Nicholasville, said he worries about the cost of Medicaid expansion in the coming years. Under expansion, the federal government will pay 100 percent of the cost for the first three years, eventually reducing its contribution to 90 percent.

“I’m very concerned for the taxpayers, the General Assembly,” Buford said. And he suggested that more effort should be spent on improving the quality of service provided, especially since so many Kentuckians rely on Medicaid for their healthcare but state health rankings remain among the worst in the nation.

Expanding Medicaid will qualify an additional 308,000 uninsured Kentuckians and, Kissner said, significantly help the working poor. Enrollment for those newly eligible is scheduled to begin Oct. 1.

Reporter Jessie Halladay can be reached at (502) 582-4081 or on Twitter at CJ_JHalladay.