Kentucky Hopes KenPAC Improvements Will Help Curb Medicaid Costs

Facing a projected $280 million Medicaid shortfall, Kentucky officials and the Kentucky Medical Association hope to control the program's costs by improving the Kentucky Patient Access and Care System, the Owensboro Messenger-Inquirer reports. KenPAC, established in 1985, assigns Medicaid beneficiaries to primary care physicians who coordinate their treatment. According to state officials, the program helps to "keep [Medicaid patients] out" of the emergency room -- one of the "biggest drains" on the state's $3.2 billion Medicaid budget -- and reduce "staggering" costs. "If a person has an established relationship [with a physician], they have a better opportunity to get earlier intervention, which is more cost effective," Ann Marks, deputy secretary for the state Cabinet for Health Services, said. Last year, a state Medicaid Managed Care Oversight Committee and the KMA discussed "enhancing KenPAC as a possible solution" to addressing Medicaid budget shortfalls. "KenPAC can work if it has some utilization reviews. If it has some ways of educating the physicians and recipients on proper ways of using the system," KMA President-elect Dr. Donald Neel said. To improve KenPAC, experts said that the state must study "overutilization" of emergency rooms, which cost Kentucky $90 million last year, and prescription drug use, which cost about $500 million. In addition, Neel said that KenPAC's "laborious" enrollment process "needs to be worked on," adding, "We're looking at getting the recipient in the office quickly." KenPAC serves about 254,000 Medicaid beneficiaries in 102 counties, representing about 60% of Kentucky's Medicaid beneficiaries statewide. About 1,500 doctors, who receive $4 per month for each patient they serve, participate in the program (Carrico, Owensboro Messenger-Inquirer, 7/16).