The Commonwealth of Kentucky is beginning a new era in its Medicaid program. Kentucky is expanding the managed-care delivery model across the state, tapping private sector expertise to increase efficiency, innovation and effectiveness. The new system will continue to deliver high quality health care to Kentucky's 815,000 Medicaid members, while helping reduce program costs.
Managed care is a proven system of care used by many Medicaid programs. Kentucky's goal is not just lowering overall costs, but, also improving health outcomes through managed care's focus on preventive services and screenings, using disease management for those with chronic health conditions and reducing unnecessary tests and use of services through care coordination.
The MCOs will coordinate physical, mental and dental care statewide for more than 560,000 Medicaid members statewide. Members in nursing homes and waiver programs will not transition to managed care coverage.
The managed care organizations (MCOs) currently coordinating health care for most Medicaid members statewide are:
- CoventryCares of Kentucky, a Medicaid product of Coventry Health and Life Insurance of Delaware, provides services in eight states;
- WellCare of Kentucky, a part of WellCare Health Insurance of Illinois, provides services in seven states.
Managed Care Update
Beginning Jan. 1, 2013, four MCOs have also been awarded contracts to provide coverage for the 175,000 Medicaid recipients in Louisville and 15 surrounding counties, also known as Region 3. Those MCOs are:
The counties in Region 3 are: Breckinridge, Bullitt, Carroll, Grayson, Hardin, Henry, Jefferson, Larue, Marion, Meade, Nelson, Oldham, Shelby, Spencer, Trimble and Washington.