HealthLeaders-InterStudy, a leading provider of managed care industry intelligence, reports that Kentucky's new Medicaid plan, KyHealth Choices, allows for cost sharing and alternative premiums, co-pays for some services, and limits for some services and medications. According to the latest issue of Ohio, Kentucky & Indiana Health Plan Analysis, such changes would previously have required a specific waiver, but can now be implemented through a simple state plan amendment.
"Kentucky is hoping to see some significant cost savings from these changes," said Rick Byrne, HealthLeaders-InterStudy analyst. "They'll be using an assortment of carrots and sticks to drive those savings. They plan to give credits to Medicaid members who practice healthy behaviors, penalize excessive use of emergency departments, and tailor benefits to different groups of recipients, like disabled adults in nursing homes, mothers and children, and working people previously not covered by Medicaid."
The program will be run almost entirely by the Kentucky Cabinet for Health and Family Services -- some of it bought outright from managed care companies that formerly served state recipients. The state will oversee benefit management, care management, and technology infrastructure. As a result, opportunities for private companies to participate will be limited.
Medicaid comprised about $4.7 billion of the state's annual $6.5 billion Health and Human Services budget in each of the last two years, while serving about 700,000 people. The federal government picks up about 70 percent of the tab for Kentucky Medicaid.
Other health plan news in Ohio, Kentucky, and Indiana: * Ohio is preparing to launch managed care for its aged, blind and disabled segment of Medicaid. * Medical Mutual has called off its possible combination with Indianapolis-based M*Plan About Health Plan Analysis
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