Look for something better to rise from the rubble.
Earlier this week, my friend and colleague Terry Boyle of Insider Louisville gave us all a heads-up that the Kentucky Medicaid Cabinet would be announcing the results of its search for additional Medicaid Managed Care Organizations (MCOs) to operate in Kentucky’s Region 3 in Jefferson and surrounding 15 counties. This prediction was spot-on. Today the Commonwealth announced it had finalized contracts with four MCOs that will begin services January 1, 2013. This is big news, and must have been a terrible disappointment for Passport and the University of Louisville.
Passport has been operating under a special Federal dispensation that permitted it to have a monopoly for the past 15 years to provide clinical care to Medicaid beneficiaries in region 3. For reasons not entirely known to me (but that I can guess) that privilege has been revoked. In less than three months, Passport will be joined by Coventry Cares, Wellcare of Kentucky, and Humana. No doubt there is much scrambling going on to assemble provider networks of hospitals and healthcare workers. Coventry Cares and Wellcare already have statewide networks of Medicaid providers, and Humana has extensive local private and Medicare networks that it may be able to call into service for Medicaid beneficiaries. In fact, Passport is lucky it has not been asked to provide a statewide network as previous MCOs were required to do. This would likely have sunk Passport and seems to me to be a major concession to them. Continue reading “A Grenade Explodes in Jefferson County’s Medicaid Managed Care.”
