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Prescribing “Promising Practices” for KY's Sick Medicaid Budget

November 24, 2010

LOUISVILLE, Ky. - As Kentucky's Medicaid rolls swell by about 3,000 new beneficiaries a month, and a legislative task force examines ways to control costs, a Kentucky group has some ideas to lend. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, says they're learning from rural health experts new ways to deliver higher-quality, patient-centered health care that saves money.

One way, she says, is to use a team approach in caring for patients, especially in under-served areas.

"The primary care physician is a team leader, with a team of effective nurses, social workers, psychologists and other necessary staff working together in the most cost-effective way."

Zepeda notes that most health expenses occur at the start and end of life. She says the state could benefit from a Western Kentucky program called Centering Pregnancy that has proven to offer savings in dollars and lives.

"In this program, groups of moms-to-be get together with a health educator. Not only are they getting their regular check-in, but they're also able to support each other with strategies to make sure they're doing everything they can to have a healthy baby. "

The Foundation for a Healthy Kentucky also urges that data be made available on how much patient care actually costs. Zepeda says Kentucky could benefit from having an all-payer and all-claims database. She also points to the importance of mental health services in delivering primary care and having a payment system that allows for these innovations.

"If you are treating a patient for a lot of aches and pains without finding out that there are underlying anxieties or depression that could be addressed, you may be spending money unnecessarily on tests and putting a patient through unnecessary procedures."

For months, a joint legislative panel has been collecting information to help them make recommendations in December on approaches to reining in Medicaid costs. Gov. Steve Beshear recently announced a plan to plug a $142 million hole in the Medicaid budget, in part by expanding managed care in the system. The $6 billion state and federal program serves roughly one in five Kentuckians.

Renee Shaw, Public News Service - KY