Feds OK managed-care Medicaid; firms advertise for enrollees

The move to managed care for Kentucky’s Medicaid patients is one step further to being implemented. The federal Centers for Medicaid and Medicare Services have approved the state’s plan to have three managed-care organizations provide care for 560,000 people statewide, The Courier-Journal reports.

Services will not change for about 170,000 people in Jefferson and 15 nearby counties, who have been receiving managed care services through Passport Health Plan for several years. Local newspapers are running advertisements from the three managed-care companies seeking enrollees.
Moving to managed care is Gov. Steve Beshear’s answer to fill a $166 million hole in the Medicaid budget, created by a lack of expected federal funding. The federal government pays more than 70 percent of Medicaid costs, bringing the expected savings to $1.3 billion over three years. Under a managed care model, the companies will be paid on a per-patient basis. State officials say there will be an incentive for the companies to keep costs down because the lump sum received for each patient will stay static, unlike in the fee-for-service model in which the state has paid for whatever bills are incurred. (Read more)
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