Monday, September 19, 2011

Medicaid's move to managed care delayed until Nov. 1; hospitals need more time to sign contracts

The move to managed care, which the state has touted as the answer to improve the quality of its Medicaid system and solve a budget deficit, has been delayed by a month in response to the Kentucky Hospital Association saying hospitals need more time to sign contracts and prepare for implementation.

"We have made great progress in Medicaid managed care since we first announced the contract awards in July," said Janie Miller, secretary for the Cabinet for Health and Family Services. "Thousands of providers have signed up with the managed care organizations ... but we still need the hospitals to sign contracts before we can implement managed care across the commonwealth."

Mike Rust, president of the KHA, said of about 100 hospitals that will be affected by the changes, only about 20 have signed contracts so far, reports Deborah Yetter of The Courier-Journal.

Four managed-care organizations, including the previously established Passport Health Plan in Jefferson and surrounding counties, will take over health-care management of the state's 730,000 Medicaid recipients. The companies will be paid a per-patient, per-month amount set by contract negotiations. Because they won't be paid using a fee-for-service model — believed to be more costly — and will try to streamline care, the move is expected to save $1.3 billion in the next three years, Miller has said.

Earlier this month, Kentucky got the green light from the federal Centers for Medicaid and Medicare Services to proceed with the transition to managed care. (Read more)

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