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Ideas for Medicaid's Future in Kentucky

Integrating dental care at the same sites as people get medical care is one idea that could make Kentucky's Medicaid program work more efficiently. (Foundation for a Healthy Kentucky)
Integrating dental care at the same sites as people get medical care is one idea that could make Kentucky's Medicaid program work more efficiently. (Foundation for a Healthy Kentucky)
May 27, 2016

LOUISVILLE, Ky. - A broad cross-section of people who are interested in how Kentucky will implement changes to its Medicaid program have spoken - and their ideas are now being made public.

Nearly 130 stakeholders were brought together earlier this month by the Foundation for a Healthy Kentucky. According to the Foundation's president and chief executive, Susan Zepeda, there was "significant consensus" on ways to make sure Medicaid in Kentucky is "safe, effective and affordable."

"I think it's fair to say that there was interest in incentives for healthy behavior, streamlined administrative processes, innovative ways to deliver care, and greater transparency and predictability of costs," Zepeda said.

The state is in the process of seeking the federal government's approval to test and evaluate new ways to provide Medicaid. Zepeda said the suggestions from providers, payers, consumers, public-health professionals and academic researchers have been shared with the team drafting the waiver request.

According to Zepeda, one of the main themes voiced at the meeting was support for integrating health services.

"It would be more effective -- cost-effective -- to deliver primary-care services on the same site, in the same location, in a coordinated manner with oral-health services and with behavioral-health services," she said.

Nearly a half-million Kentuckians have gained coverage through Medicaid expansion, making Kentucky the state with the greatest decrease in its uninsured rate. But Gov. Matt Bevin said the state can't afford to continue down the current path, and that he's banking on a federal waiver to improve health outcomes and encourage personal responsibility in what he called "a fiscally sustainable manner." Because the state still is drafting its waiver request, Zepeda said the discussions about cost-sharing by Medicaid participants centered on experiences in other states.

"There, I think, in the conversation, the preference tended to be toward a premium payment," she said, "largely because that would be a known amount, a predictable amount, that people could budget -- whereas the co-pays sometimes can lead to surprises."

A related report is online at healthy-ky.org.

Greg Stotelmyer , Public News Service - KY