Glasgow Daily Times, Glasgow, KY

Local News

February 6, 2013

Verdict still out on new managed care system

FRANKFORT — Sometimes it’s all in the eyes of the beholder.

On Wednesday, the House budget subcommittee on human resources heard reports on how well the new managed care system of delivering Medicaid is working — and how terribly it’s working.

Sharon Clark, insurance commissioner, told the committee that the first quarter of Medicaid implementation “was kind of rocky” as complaints about failure to pay or late payment of fees rolled into the Department of Insurance.

But since then, Clark said, complaints about Medicaid and managed care “are not totally out of line” with the number of problems or complaints about private insurance.

Audrey Haynes, secretary of the Cabinet for Health and Family Services which oversees Medicaid, told the same committee that 14 years ago when managed care was introduced into Jefferson County and surrounding areas, there were similar complaints.

Now Passport (and recently three other companies offering managed care in the same region) is viewed as a model of care and gets good reviews from patients and providers. That’s no excuse for today’s problems, she told the lawmakers, but it does show the change “is a major culture shift” and such early problems shouldn’t have been unexpected.

But Daniel Parietti, senior vice president of Centene, the parent company of Kentucky Spirit, a managed care company which wants out of its contract in Kentucky, said the system and Kentucky face “an imminent financial crisis.”

Kentucky last year moved to a managed care system in which the state pays companies a contracted per-patient amount to cover all Medicaid services rather than reimburse medical providers on a standard fee-for-service basis.

The idea is to save money and offer more up-front preventive care which should save costs for later treatment of conditions which might have been prevented or at least managed better if treated earlier.

Read the full story in Thursday's print or e-edition of the Glasgow Daily Times.

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