Other states view Ky. as cautionary tale with managed care transition, consultant says
03/14/2012 07:01 PM
States like Kansas that once looked to follow Kentucky into the world of managed care of Medicaid now are trying to learn from the state’s mistake of rushing into it, said health care policy consultant Shannon Turner.
“In the beginning, he was heralding Kentucky,” Turner said at 10:15 of the video. “And last week, his office issued what I call a ‘Kansas is not Kentucky’ ““statement”“:http://governor.ks.gov/frontpagenews/2012/03/07/lt.-governor-kancare-delay-would-be-costly-mistake … because Kentucky has gotten so much bad press on the way the providers and the patients are being treated under managed care.”
Turner, a former Kentucky Medicaid commissioner who was fired from the Passport Health Plan after controversy over travel expenses, co-owns a consulting firm that has been working with states like Kansas. .
“First, I don’t think there was enough ramp-up time,” Turner said (2:50).
Kentucky’s Medicaid Department requested proposals from managed care organizations to bid on the contracts in November and the three companies went live on Nov. 1. Find out how much time Turner said other states have needed (3:20).
Turner also addressed the audit report from December 2010 that showed Turner and other former executives spent excessively on travel, food and lobbying.
“While it was a controversy, we have moved on,” she said, speaking also for Nici Gaines, another former executive who
The state hired these three managed care companies to handle the health needs — almost like insurance companies — for many of the 820,000 poor and disabled Kentuckians who rely on Medicaid. Previously, the Passport program in Louisville and its 15 surrounding counties was the only managed care set-up in the state.
Doctors, hospitals, mental health facilities and dentists have complained in legislative hearings that they’re not getting paid in a timely manner by the three new managed care organizations. They’re also reporting problems with pre-authorization approval for basic services, including delivering babies.
Meanwhile, those managed care organizations aren’t getting much help from the state’s Health and Family Services Cabinet.
“The managed care companies don’t really have the resources they need on the state level to give them direction. I think that’s a huge issue,” Turner said in the interview. (4:40)
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