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KY Medicaid Awarded for Exceeding Quality, Patient Care

Kentucky’s BCBS Medicaid program has received prestigious NCQA award for quality and patient protection.

Kentucky's Medicaid program is awarded for quality

Source: Thinkstock

By Jesse Migneault

- Kentucky’s Anthem Blue Cross and Blue Shield Kentucky Medicaid has received an award from the National Committee for Quality Assurance (NCQA) for its Medicaid managed care plan. 

The award recognizes the plan’s service and clinical quality that meet or exceed NCQA rigorous requirements for consumer protection and quality improvement.  

"Health plans that step forward to participate in NCQA's New Health Plan Accreditation Program early on in their history are to be especially commended,” said Margaret E. O’Kane, NCQA president. “Our standards are rigorous, and by meeting them, Anthem Blue and Cross Blue Shield Kentucky Medicaid has shown that it is well designed and serious about the quality of care it provides."

The award is different than the NCQA's Health Plan Accreditation Program, recognizing programs that are less than three years old. The New Health Plan Accreditation is valid for three years.

Kentucky’s Medicaid managed care plan coordinates physical health, behavioral health, dental care, and vision services for over 119,000 residents across the entire state.

Anthem BCBS launched its Kentucky Medicaid plan in 2014.  Since then, the health payer has been the recipient of several contracts to expand its Kentucky Medicaid offerings as well as expand into the Kentucky Children’s Health Insurance program (KCHIP).   

“This accreditation is a reflection of Anthem’s commitment to developing and delivering quality products and services that meet the unique needs of our members,” said Anthem Blue Cross and Blue Shield in Kentucky President Cecelia Manlove.

“It is an honor to be acknowledged for providing quality, effective care to our members, and we thank our associates and provider partners for all the hard work that went into achieving this award,” she continued.

Kentucky has long been in the crosshairs of the ACA Medicaid expansion debate.  Kentucky was one of 31 states to join the ACA Medicaid expansion program in 2014 and has undergone dramatic effects. 

The number of uninsured residents in the state has seen a 12.6-percent drop between 2013 and 2016, the largest decrease in the nation.

The success of the state’s Medicaid expansion program, Kynect, has transformed the state which ranked 44 out of 50 in general health into a national model of participation and improvement in public health programs.

In 2016, nearly one-third of Kentucky’s population received healthcare through an ACA Medicaid expansion program.

Recent gains in coverage may be about to change.  Kentucky Governor Matt Bevin (R) submitted a Section 1115 waiver in 2016, which would enable the state to opt out of mandated coverage regulations in the state’s Medicaid expansion program.

Kentucky joins Maine as part of a national trend, as more states look for flexibility and apply for Section 1115 waivers.  

The Maine waiver has proposed changes which would increase the level of patient responsibility for Medicaid beneficiaries, include a work requirement, charges for missed appointments, asset reviews, and a new monthly premium.

Earlier in 2017, HHS Secretary Tom Price sent a letter to the nation’s governors encouraging them to utilize the waiver option to modify Medicaid and other ACA regulations in their state healthcare systems.

HHS must approve the waiver requests before state officials can put them into effect.

The decision on the Kentucky waiver is expected in June 2017, and if approved will institute a revised Medicaid model, Kentucky Health.

The reform comes despite a 72-percent approval rating from Kentucky residents for the existing Medicaid expansion services.   The waiver would allow the state to cut large groups out of Medicaid, or make qualifying for coverage difficult or impossible.

According to the governor at a recent town hall, this reform is an effort to make those currently receiving needed healthcare feel less like a “ward of the state.” 

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