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Medicaid contract in critical condition
May 11, 2012 | 9136 views | 0 0 comments | 18 18 recommendations | email to a friend | print
Gov. Steve Beshear may need more than sutures when trying to repair the damage to some of our region’s health care facilities and its patients.

In fact, the problem seems to be spreading like a rapid virus as we learn that ARH is no longer in isolation by Coventry Cares in attempts to escape the contract it has with the state for health care coverage for a large percentage of people in our region.

We believe the governor should seek experienced specialists as he analyzes the cause for the problem that as of now has spread to Baptist Health Care and King’s Daughters Medical Center — the latest victims of Coventry’s attempt to renegotiate the contract it entered into with good faith with the Commonwealth.

Managed care might actually work if you get your priorities straight and manage people first and the money second. So far, no evidence exists that these MCOs are making any serious attempt to manage their clients to access health care providers in a more appropriate and cost-effective manner. So far their approach seems to be to receive taxpayer dollars, hold onto as many of them for as long as they can, and then cut patients off to protect their corporate balance sheets. Health care finance may be a complicated mess, but then often so is life. Medical care should be first about the lives, not the funds.

We had prepared an editorial for this space last week encouraging our local residents to rally around ARH and for the governor to step up and lead the effort to hold Coventry to their contract. While the crisis has lessened for now with a contract extension, we still believe this and encourage Beshear to get to the bottom of how a company like Coventry could miscalculate the poverty in our region and agree to a contract it cannot fulfill. Contents of future contracts should be clearly researched.

Clearly it is a good faith business deal that went sour as a result of Coventry failing to do its homework, the failure to know the area it sought to represent while gaining financially. It has caused needless aggravation on our health care professionals, agony for many of the subscribers to Coventry who utilized ARH, Baptist and now King’s Daughters.

We can’t emphasize enough that the whole scenario focuses on poverty in our county and across eastern Kentucky. It is our hope that the powers that be — the governor, state and federal House and Senate leadership, and all those other players who make funding decisions in Frankfort and Washington, realize our region is hurting and has been for years. We have repeatedly called for better roads, for help with economic development, for better education facilities, to no avail. We continue to believe, and to hope, that we can’t be ignored forever.

Our people are frustrated and we don’t blame them. The unemployment lines are growing daily as a result of the loss of mining jobs due to bureaucracy in Washington. We’re frustrated right along with our people. Our region clearly is in reverse to progress that once was made as a result of the war declared on poverty.

Most of our county supported you Gov. Beshear in your bid for reelection. You were successful. Please don’t take our votes and run. We want and expect to see you fighting for our county, and for our entire region.

There’s no better time for you to take the lead than now, especially on one of the most critical conditions we face — the health care crisis that has evolved at your doorstep.
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