As Managed Care Transition Continues, Ongoing Issues are Cause for Concern

In November 2011, Kentucky Medicaid changed the way it operates its Medicaid program by expanding managed care coverage to all areas of the state. Medicaid contracted with three new managed care organizations (MCOs) to coordinate health care for most Medicaid members. The new MCOs are: CoventryCares of Kentucky, Kentucky Spirit Health Plan and WellCare of Kentucky. This change did not affect members in Jefferson County and the 15 surrounding counties served by the Passport Health Plan.

“We are in a pivotal place, where we could either improve or damage the health outcomes for Kentucky’s kids,” said Andrea Plummer, Senior Policy Analyst for Kentucky Youth Advocates. “The Kentucky Medicaid program serves some of our most vulnerable populations, and there is no room for lack of attention to detail during the transition process.”

Managed care could result in many positive outcomes including improving quality and coordination of health care, increasing access, and cost savings for the state. However, since implementation in November 2011, we have seen many issues arise causing disruption in care and frustrated members and providers. In order to track the success of the transition for the Commonwealth’s kids, Kentucky Youth Advocates launched a Medicaid Managed Care Story Bank Hotline.

“Throughout this transition and beyond implementation, Kentucky Youth Advocates is committed to making sure children are not dropped from Medicaid and KCHIP and that they receive the health services they need and are eligible for. We want to document stories about what is working well and what needs to be improved in Medicaid managed care so we can better advocate around this new system,” said Plummer.

Personal stories, both positive and negative, can be shared on the Kentucky Medicaid Managed Care Story Bank Hotline. To access the hotline, individuals should dial 1-888-825-5592 and press 1 when the welcome voicemail begins. Calls during non-business hours, or when someone is not available to take calls, can be left over the hotline voice mailbox. Stories can also be documented electronically at the Kentucky Voices for Health website. Click  here to access this form.

For help with questions about Medicaid managed care health plans such as covered benefits and available providers for each plan, members can call the state helpline at 1-855-446-1245 from 8 a.m. to 6 p.m. Eastern Time, Monday through Friday.

Download a pdf of this news release Kentucky Medicaid Manage Story Bank Hotline .