Policymakers Need to Consider Children While Negotiating Managed Care Contracts

Statement by Terry Brooks, Executive Director, Kentucky Youth Advocates

“The Request for Proposals for Medicaid Managed Care Organizations was released today and we are pleased to see the document requires specific considerations for children, including children in foster care, school based services, newborns, and children with special health care needs.

As the Commonwealth takes steps towards expanding Medicaid managed care in Kentucky and begins to review proposals, it is crucial that we not only look to increase efficiencies within state government, we must also look to improve health outcomes for all. Managed care could naturally translate into improved access to needed care, but if plan or provider participation is inadequate, eligibility for Medicaid unstable, or the unique needs of the Medicaid population are overlooked, children could be in serious danger.

At this point, the national experience with managed care has been both positive and negative. In some cases, managed care has produced dramatic savings and improved health outcomes. In other cases, the reverse has occurred, and the cost-saving strategies used by managed care companies have compromised the well-being of plan members by making it more difficult to navigate an already complex health care system. The national lesson is clear – managed care can be a catalyst to or a barrier for children’s health outcomes.

We will stay informed on the process as the state moves forward with managed care and evaluate its potential impact on children. For example, we will specifically be looking at managed care’s role in school based health services –  we know what kind of catalyst this can be, but we also seen the unintended consequences in the Passport region which severely limits health care provision in schools

We are hopeful that Governor Beshear will ensure both an increase in efficiencies, and the impact it will have on the well-being of our state’s most venerable population, our youth, before any managed care option becomes a reality.”

Download a pdf of this news release Policymakers Need to Consider Children While Negotiating Managed Care Contracts.