health

Phil Galewitz/Kaiser Health News

For Freida Lockaby, an unemployed 56-year-old woman who lives with her dog in an aging mobile home in Manchester, Ky., one of America's poorest places, the Affordable Care Act was life altering.

The law allowed Kentucky to expand Medicaid in 2014 and made Lockaby – along with 440,000 other low-income state residents – newly eligible for free health care under the state-federal insurance program. Enrollment gave Lockaby her first insurance in 11 years.

"It's been a godsend to me," said the former Ohio school custodian who moved to Kentucky a decade ago.

Lockaby finally got treated for a thyroid disorder that had left her so exhausted she'd almost taken root in her living room chair. Cataract surgery let her see clearly again. A carpal tunnel operation on her left hand eased her pain and helped her sleep better. Daily medications brought her high blood pressure and elevated cholesterol level under control.

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Consumer advocates are advising people to not buy into the name “multi-state” plan when shopping for individual market health insurance for next year because the plans don’t necessarily offer coverage across state lines.

Susan McConkey, a health insurance broker, said many consumers assume “multi-state” means coverage across state lines at in-network prices. But that isn’t true in most states, including Kentucky.

“They think they can use it in any state, and that’s not the case,” McConkey said.

The Office of Personnel Management in Washington, D.C. was assigned the task of getting insurers to offer these plans because of the agency’s experience managing federal employee health insurance.

Beth Hadley is in charge of multi-state plans at OPM. She acknowledged that the name is misleading, and said the agency is considering changing the name.

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Kentucky has earned the unhealthy distinction of being the fifth “fattest” state in the U.S.  

A report from the consumer website WalletHub shows that only Mississippi, Louisiana, Arkansas and South Carolina have a higher percentage of obese or overweight residents than Kentucky.

The Bluegrass State ranks second in the nation for the number of residents with high cholesterol, fourth for diabetes, and fifth for high blood pressure.

Bonnie Hackbarth is a spokeswoman for the Foundation for a Healthy Kentucky. She says creating a healthier state starts with consistent health care.

“Part of the answer in improving Kentucky’s health is getting more Kentuckians insured, so that they’ll take advantage of the kind of preventive services that will improve our health overall.”

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Sharon Bush spent 30 minutes on Tuesday helping a client sign up for an email account. The email address is a necessary step in signing up for health insurance through Healthcare.gov.

Bush didn’t realized that the email requirement for the federal exchange would take up so much time.

“In southeastern Kentucky, there are a lot of people who don’t have and/or use technology,” Bush said. “[The client] is a grandmother in her early 60s, and she just said, ‘I have two granddaughters and they use it a lot.’”

Bush works in Manchester, Kentucky, at Grace Community Health Center, where she helps people sign up for health insurance. She’s a former Kynector, a person paid by the state to assist people with enrollment. She helped people last year find health insurance through Kynect and is now helping people sign up on the federal exchange at Healthcare.gov.

In early October, Gov. Matt Bevin was given approval by the federal Centers for Medicare and Medicaid Services to dismantle the state-based insurance portal, Kynect, leaving Kentuckians searching for insurance to go through the federal portal, Healthcare.gov.

Centerstone

Seven Counties Services, Inc. is no more.

The mental health provider announced Monday that it officially merged with not-for-profit Tennessee-based Centerstone and will now be known as Centerstone of Kentucky.

For the coming months, patients won’t see any changes. But in the next two years, Centerstone plans to expand services and do more research.

Centerstone, which started in 1991, offers mental health services in Florida, Illinois, Tennessee, Indiana and now Kentucky. Starting Tuesday, Tony Zipple, president and CEO of Seven Counties, will become CEO of Centerstone of Kentucky.

Zipple said the merger means the local provider will have more resources for services like setting up “health homes” for people with serious mental health and medical conditions.

Kentucky Cabinet for Health and Family Services

Kentuckians trying to get health insurance through the state-based marketplace will use healthcare.gov instead of Kynect starting Nov. 1.

Personal information of those who previously used Kynect to get insurance will not be transferred to the federal platform, so consumers will have to reapply on the federal website.

Gov. Matt Bevin’s administration says the move will save the state about $10 million per year in operating costs.

“Health insurance is a vital piece of maintaining health and well-being,” said Health and Family Services Cabinet Secretary Vickie Yates Brown Glisson in a statement. “We want to make sure Kentuckians interested in purchasing a qualified health plan know where to shop. Anyone with questions or who encounters difficulty with enrollment is encouraged to contact a call center for assistance.”

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Daviess County doctors are treating as many as 500 patients who are suffering from a once-rare allergy.

Alpha-gal syndrome is spread through tick bites, and leads to allergic reactions after the eating of red meat.

Physicians at Owensboro’s Allergy and Asthma Specialists are seeing an explosion in the number of people diagnosed with the allergy.

Physician assistant Caitlyn Renaud says Alpha-gal is different from a regular allergy because of its delayed reaction time.

“People had dinner at, like, 7 o’clock at night and they ate a steak or cheeseburger. And they would wake up in the middle of the night with swelling, hives, and itching,” she said.  

Other symptoms of Alpha-gal syndrome include abdominal cramping and vomiting.

The allergy especially prevalent in the south-east because of the number of ticks found in the region.

Kentuckians in more than half of all counties who buy insurance through HealthCare.gov next year will have a much more limited choice of doctors and hospitals.

That’s because the only insurer left in Kentucky offering exchange plans in all 120 counties — Anthem Blue Cross Blue Shield — will only offer an HMO plan in 74 of those counties starting Jan. 1.

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U.S. Rep. John Yarmuth is calling on Gov. Matt Bevin to withdraw his request for a Medicaid waiver, saying that the federal government will never approve it.

Bevin has applied for the waiver to allow Kentucky to charge monthly premiums to Medicaid recipients earning more than $11,880 a year and remove vision and dental coverage, among other changes.

The proposal also includes a ‘rewards’ account that would allow people to earn vision or dental benefits by doing things like volunteering, applying for jobs or earning a GED.

Yarmuth says he’s communicated with officials at Centers for Medicare and Medicaid services and they told him the waiver would not be approved as-is.

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Whether or not your doctor stays in business over the next few years could hinge on their ability to adapt to a new regulation changing how Medicare pays doctors and clinicians.

The game-changing regulation aimed at paying medical providers for quality instead of quantity is known as MACRA. It’s based on legislation passed last year by Congress to overhaul how Medicare pays doctors.

There are two routes medical providers can take: Medical practices can earn higher reimbursements if they learn new ways of doing business. That includes being willing to accept financial risk and reward for performance, reporting quality measures to the government, and using electronic medical records. The majority of medical practices will go this route, according to the Kentucky Medical Association.

Or they can join a network of medical providers and hospitals that shares financial and medical responsibility for providing coordinated care to patients in hopes of limiting unnecessary spending.

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Ten months after completing a smoking cessation class, Terrence Silver started smoking cigarettes again. It was his first attempt at quitting after smoking for 40 years. His biggest motivation to quit: cost.

“That was the primary reason I was going to quit, the money,” Silver said. “It wasn’t health, wasn’t that I didn’t like it. It was the money.”

Silver lives across the river in Jeffersonville, Indiana, where the tax on cigarettes is 99 cents per pack. So he comes to Kentucky to buy his cigarettes, where the tax is 60 cents.

Silver said when he took the smoking cessation class in April of 2015 — offered through the Metro Department of Public Health — he learned about his triggers: every time he gets in his car, he reaches for a cigarette.

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A new study shows fewer Kentucky adults are delaying or skipping medical care because of cost concerns.

The report from the Foundation for a Healthy Kentucky says a little more than 20 percent of Kentuckians who are 18 and older put off treatment this year because they couldn’t afford it.

That’s a big improvement over the 32 percent who skipped or delayed medical care in 2009.

“It’s still too high a figure, and we’re still higher than the national average,” said Foundation President and CEO Ben Chandler. “But it’s certainly better than what it was, and it’s a good sign and a step in the right direction.”

Chandler says the increasing number of Kentuckians who have health coverage under the Affordable Care Act has made a big difference. He points out income level is also a big predictor of whether Kentuckians had to put off getting medical care.

Kentucky Cabinet for Health and Family Services

Kentuckians who’ve purchased health insurance via Kynect will have to re-enroll on the federal exchange starting Nov. 1.

The Centers for Medicare and Medicaid Services on Tuesday told Gov. Matt Bevin that all major milestones for the switch had been met. As of this year, 74,640 people were enrolled via the state health care exchange, Kynect.

This means if you currently have coverage that was acquired on the state exchange, you will have to re-enroll on the federal exchange at healthcare.gov. Officials said that’s due to consumer information not being transferred from Kynect. 

Adam Meier, Bevin’s chief of staff for policy, said people can be screened for Medicaid eligibility or a plan on the federal exchange via the Benefind website, which operates as the umbrella portal for Kentuckians to apply for nearly all entitlement services.

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If you go to the hospital this year, there will likely be a small decrease in your bill from previous years.

That’s because hospitals in Kentucky saw the lowest rates of charity care in 2015 since before Medicaid expansion went into effect four years ago.

But it might not last.

Charity care refers to the services hospitals provide patients who can’t pay because they don’t have insurance. Hospitals get paid back for this partially by the state and federal government, but they pass the remaining cost on to insured people.

In 2015, Kentucky hospitals had $552 million in charity care costs, compared with $2.4 billion four years ago.

The findings on uncompensated care come from a new report from the Foundation for a Healthy Kentucky report out last week.

A big reason for the dip is likely from the state’s expanded Medicaid program.

Baptist Health Plan To Stop Selling Insurance In Kentucky

Oct 3, 2016
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Baptist Health Plan says it will not sell policies in Kentucky next year, meaning about 7,000 people will have to find a new insurance provider.

Kentucky’s fourth-largest insurer notified state officials in a letter. In a news release, state officials say company President James S. Fritz said Baptist Health Plan had enrolled more people than it planned and said federal risk assessments imposed by the federal Affordable Care Act are “unsustainable.”

The company’s insurance plans sold on the state’s health exchange will be good through Dec. 31. Plans sold off the exchange will expire March 31, 2017.

The news means next year people in 59 counties will have one insurance provider selling plans on the state health exchange. Off the exchange, most counties will have two options, state officials said.

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