Medicaid

Kentucky Spent $3.7M On Gunshot Victim Care In 2014

Feb 1, 2017
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The average cost of a gunshot victim’s emergency room or hospital stay in Kentucky was $10,000 in 2014. That’s according to a report out from the Urban Institute.

The total costs of these stays was $3.7 million, with the majority coming from inpatient stays.

And most of that care was provided by a government program. In 2014, the majority of gunshot victims in Kentucky hospitals — 68 percent — had their care paid for by public insurance like Medicaid. In 2010, 54 percent of gunshot victims had no insurance at all. Kentucky expanded its Medicaid program to childless adults in 2014 as part of the Affordable Care Act.

As Congress weighs repeal of the Affordable Care Act, the home state of Vice President Mike Pence Tuesday sought to keep its conservative-style Medicaid expansion under the federal health the health law.

Gov. Matt Bevin’s administration is moving forward with a plan that would alter the state’s expanded Medicaid system, even if the Affordable Care Act is repealed or replaced by Congress.

The proposal has been billed as a way to get Medicaid recipients more involved in their healthcare choices and also a way to reduce Medicaid costs for the state. Bevin’s administration expects about 86,000 fewer people would be enrolled in Medicaid if the waiver is approved.

Vickie Yates Brown Glisson, secretary of the Cabinet for Health and Family Services, said on Wednesday that the state would still move forward with the plan, even if Congress moves to fully repeal the Affordable Care Act.

Kentucky’s Medicaid expansion has led to a dramatic increase in substance abuse treatment services. The Foundation for a Healthy Kentucky has examined substance abuse services covered by Medicaid between 2014 and mid-2016.

 

The group’s report found that Medicaid beneficiaries received 740-percent more treatment services for substance abuse issues over that 30-month period. Before the Affordable Care Act in 2012, about 585-thousand Kentuckians lacked health insurance, and therefore had no coverage for drug and alcohol treatment services.

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To get a glimpse of where Medicaid may be headed after Donald Trump moves into the White House, it may be wise to look to Indiana.

That’s where Seema Verma, Trump’s pick to run the Centers for Medicare and Medicaid Services, comes from. And that’s where she put her stamp on the state’s health care program for the poor.

Verma is a private consultant who was hired by Indiana Governor and Vice President-elect Mike Pence to design a Republican-friendly expansion of Medicaid under the Affordable Care Act. The state paid her almost $5 million over four years through 2017, according to the contracts.

Healthcare.gov

More than 30,000 Kentuckians have signed up for health insurance since the state transitioned to the federal exchange on November 1.  Healthcare.gov replaced the state’s previous insurance portal known as Kynect.  This time last year, more than 27,000 Kentuckians had enrolled in coverage, according to state officials. 

Melissa Grimes works for Community Action of Southern Kentucky, which serves 11 counties.  She oversees the assistors who are trained to help enrollees navigate the online process.  Grimes says it’s taking longer to enroll people under the federal exchange.

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More than 8,500 people with expanded Medicaid coverage got breast cancer screenings in May and June of this year. And more people covered under the expansion received dental, diabetes, Hepatitis C and colorectal cancer screenings.

That’s according to a report released Monday by the Foundation for a Healthy Kentucky.

In a news release, foundation president and CEO Ben Chandler said one of the benefits of getting more people covered is that they can take advantage of preventive services “that can lead to improved health and lower health care costs in the long run.”

“That positive trend is what we’re seeing in Kentucky in terms of breast and colorectal cancer screenings, preventive dental services and diabetes and Hepatitis C screenings for Kentuckians with low incomes,” Chandler said.

Under the Affordable Care Act, former Kentucky Gov. Steve Beshear expanded Medicaid in 2014 to childless adults earning up to around $15,000 a year. Gov. Matt Bevin submitted a proposal to the federal government earlier this year to trim back benefits like dental and vision.

Report: More ER Patients Now Paying With Medicaid

Nov 18, 2016
Sts. Mary & Elizabeth Hospital

The number of emergency room visits in Kentucky hasn’t gone up much since Medicaid expanded or people started getting coverage on the individual market. That’s according to a new report from the Foundation for a Healthy Kentucky.

Before the Medicaid expansion, many uninsured Kentuckians were going to the emergency room instead of a primary care doctor for non-emergency treatment because they could not be turned away.

Now, more of them have Medicaid coverage, but they’re using the coverage for the same type of ER visit. The percentage of people in the emergency room with Medicaid coverage did increase quite a bit by 2015, with almost half  covered by Medicaid. That’s up from 30 percent in 2012.

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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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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.

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For at least the next seven months, give or take, there’s no need to worry that the proposed changes to expanded Medicaid benefits will affect your coverage.

Seven months is the average time it takes for the federal government to negotiate with a state over changes to Medicaid. And even then, some of the changes likely won’t happen.

On Wednesday, Gov. Matt Bevin submitted those proposed changes via what’s called a “Medicaid demonstration waiver” to the U.S. Department of Health and Human Services.

The Affordable Care Act was originally designed to extend Medicaid to residents in all 50 states who earn below 138 percent of the federal poverty limit, or $16,394 in 2016. But the Supreme Court famously struck down that provision.

Most states expanded Medicaid as the ACA plan set out several years ago. But a handful of states, now including Kentucky, have applied for waivers to change what the federal government intended for expansion.

Bevin Submits Medicaid Plan Restoring Allergy Testing

Aug 24, 2016
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Kentucky Gov. Matt Bevin says he has changed his proposal to overhaul the state's Medicaid program and submitted it to the federal government for approval.

The new proposal will cover allergy testing and private duty nursing for about 400,000 Kentuckians who have health insurance through the state's expanded Medicaid program under the federal Affordable Care Act. People who are in hospice care, have HIV or AIDS and receive federal disability benefits will also not have to pay premiums or copays.

And the elimination of automatic dental and vision benefits will be delayed by three months. People can still get those benefits by earning credits in a "My Rewards Account" by doing things like earning a GED and having a health assessment.

Bevin said his administration received nearly 1,350 public comments on the proposal.

J. Tyler Franklin

The secretary of Kentucky's Cabinet for Health and Family Services says officials will be making some changes to Gov. Matt Bevin's Medicaid proposal.

Vickie Yates Brown Glisson told the state Medicaid Oversight and Advisory Committee on Wednesday that officials are still reviewing the public comments submitted on the proposal. She said the comments were "thoughtful and very helpful." She did not detail what the changes might be.

Kentucky was one of 32 states that expanded its Medicaid program under the federal Affordable Care Act. More than 400,000 were covered under the expanded program, which Bevin says is too large for the state to afford.

Bevin's proposal would charge small premiums to able-bodied adults, and it would require them to have a job or volunteer for a charity in order to keep their benefits.

Kentucky Reopens Medicaid Waiver Comment Period

Aug 9, 2016
LRC Public Information

Kentuckians who missed the chance to give input on proposed changes to state-run Medicaid now have until the end of the day on August 14 to comment.

Officials with the Kentucky Department for Medicaid Services say the comment period was reopened because of the high volume of remarks received after the original July 22 deadline.

“We got 30 percent of comments on the last day and even some after the deadline,” said Jean West, Cabinet for Health and Family Services communications director. “So we decided to extend it to accept the comments that came right after the deadline and allow any others.”

She said the state has not determined a date for submission of the revised waiver to the federal government. That will allow officials time to go through comments, she said.

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After the state expanded Medicaid under the Affordable Care Act in 2014, low-income Kentuckians made fewer trips to the emergency room, had less trouble paying medical bills, received a checkup and sought help for chronic conditions. That’s according to a new study released Monday from the Harvard Chan School of Public Health.

Researchers surveyed almost 3,000 low-income Kentuckians in 2013, 2014 and 2015. Participants were asked about their coverage and about their health habits, including if they skipped doses of medication, had a personal doctor or had any emergency room visits in the past year.

In 2013, prior to the Medicaid expansion, 46.3 percent of Kentuckians surveyed said they had a checkup in the past year. Of those surveyed in 2015, after the expansion, that number increased to almost 59.8 percent. There was also a big jump in the number of people who said they had a primary physician after the expansion – from 56.6 percent to 71.7 percent.

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