Kentucky’s plan to revamp its Medicaid program by offering participants different benefits to suit their health problems has been approved by the federal government, officials said in Frankfort, Ky.
The new coverage will tailor benefits to the needs of different patient groups, rather than a “one-size-fits-all” model, said Mark Birdwhistell, secretary of the state’s Health and Family Services Cabinet. State officials will begin implementing the changes over the next month.
“We needed to greatly modernize the existing Medicaid program and convert it from a program to a health plan,” Birdwhistell said.
Under the plan, Kentucky’s Medicaid program will essentially offer participants different health plans depending on their conditions. It will also offer “disease management” programs to help patients better handle their illnesses.
Depending on their plans and income levels, some patients will be required to pay copays on certain medical procedures. The plan will also seek to limit participants’ non-emergency visits to emergency rooms and cut unnecessary monthly prescriptions.
Gov. Ernie Fletcher, who came into office facing a multimillion-dollar deficit in the state’s Medicaid program, said the new structure was “remarkable.”
“It’s landmark reform, and it’s reform that will be modeled, I believe, across the United States,” Fletcher said.
The plan will take effect later this month, officials said. By focusing on preventive care and teaching patients how to better care for themselves, the state will offer improved coverage and save money, Birdwhistell said.
Dennis Smith, director at the federal Center for Medicaid and State Operations, said the plan will help provide patients with better health care options.
“You are now focusing benefits on the people who need them and to tailor the benefits around their unique situations,” Smith said. “Medicaid is made up of different populations. But in the past it was just all or nothing.”
Sheila Schuster, executive director of the Kentucky Mental Health Coalition, said she thought the state was “very responsive” to patients covered by Medicaid because it could have probably raised patient copays but chose not to. Instead, state officials worked with consumers in crafting the plan, Schuster said.
“I keep looking for a downside, and I haven’t found one,” Schuster said.