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Experts Discuss Bumps on Road to a Healthier KY

PHOTO: Taking the pulse of Kentucky's health-care system, experts gathered Tuesday to share ideas on ways to reshape the delivery of care. Photo by Greg Stotelmyer.
PHOTO: Taking the pulse of Kentucky's health-care system, experts gathered Tuesday to share ideas on ways to reshape the delivery of care. Photo by Greg Stotelmyer.
September 17, 2014

LOUISVILLE, Ky. - In the midst of sweeping health-care reform in Kentucky, hundreds of people gathered in Louisville on Tuesday to explore how to "do care differently."

Dave Bolt, deputy director of the Kentucky Primary Care Association, said it's time to move away from what he calls a "treat 'em and street 'em mentality." To reshape the way care is delivered, Bolt told the crowd, a more common-sense approach is needed, putting the patient first, "and finally, to the realization that good health is an investment in the future of the Commonwealth, much as education, roads or sewer systems."

Experts also touched on the topics of changes in the health-care workforce, and how changes in payment are driving the delivery of care - including a focus on prevention.

Sheila Schuster, who chairs the Advocacy Action Network, a coalition of 250 organizations, said the key to reshaping health care is collaboration.

"We're not playing very well with each other in the sandbox," she said. "We spend more time and energy and money fighting with each other."

In some cases, Schuster said, people who are well trained and qualified are being left out of the decision-making process about what services to deliver and how. She used certified midwives as an example, and mentioned the fact that there are no birthing centers in Kentucky.

As deputy secretary of the Kentucky Cabinet for Health and Family Services, Eric Friedlander likened the changes in health care to an "earthquake" in the past five years. Kentucky has expanded Medicaid and switched it from a fee-for-service system into managed care, and he said there's still much that has to be done differently.

"We have to look at certificate-of-need reform. We have to look at licensure reform. We have to look at workforce and workforce reform. We need to bring more services into the communities," Friedlander said. "And, the biggest thing, and what is going to be the most difficult for us all, is payment reform."

Friedlander told the forum that Kentucky also has a long way to go to improve long-term care and community-based services.

Greg Stotelmyer , Public News Service - KY