Medicaid Modernization to Begin Saturday

By: Jon Hardison
By: Jon Hardison

Medicaid has become one of the state's biggest budget drains, and now the health care program is trying to heal itself.

A recent fact-finding study shows some alarming stats about the program.

  • More Kentuckians are enrolled in Medicaid than in public schools.

  • Fifty-nine Medicaid-funded nursing homes have inappropriate drug use among patients.

  • Up to 60 percent of patients in long-term care are on antipsychotic medications, a percentage significantly higher than other states.

  • Of those, 2,700 take doses far exceeding FDA recommendations.

  • 33,000 Medicaid recipients receive 20 or more prescriptions in an 180-day period, at a cost of $300 million.

Medicaid administrators have a three-pronged attack to address the ballooning Medicaid budget deficits:

  • Benefit management
  • Care management
  • Cost-saving technology

The first phase, benefit management, will begin on Saturday, when health care contractor First Health takes over the prescription requests and payments for the Medicaid program. First Health will use computer technology to monitor prescriptions in real time and alert pharmacies to over-prescribing or dangerous drug mixes, which could save patients’ lives and save the state money.


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