Kentucky hospitals agree to higher quality metrics for increased Medicaid payments

Kentucky hospitals are set to receive between $800 million and $1 billion in additional funding each year if they agree to new quality metrics for Medicaid patients, Gov. Andy Beshear said Jan. 19. 

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The additional funding comes after the Kentucky Cabinet for Health and Family Services received approval from CMS Jan. 14 for a new model that increases inpatient Medicaid payments to hospitals. The payments could begin in March if the plan gets approval from the Kentucky General Assembly and additional federal approvals.

Hospitals have agreed to cover the increased cost of the program so it won’t add additional costs to the state. In a news release, Nancy Galvagni, president and CEO of the Kentucky Hospital Association, said the new payment plan “will mean the difference between keeping the lights on rather than locking the doors for a number of our hospitals.” Kentucky is home to 112 hospitals, with up to 28 at risk of closing.

To receive the funds, hospitals have agreed to meet higher quality standards that will be created by the Cabinet for Health and Family Services and the Kentucky Hospital Association. 

More than a third of Kentucky residents — 1.6 million-plus — are enrolled in Medicaid. The state’s Medicaid program is managed by commercial payers. 

More articles on payers:
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Optum expects to add 10,000 physicians this year
Lawsuit accuses Cigna of using COVID-19 hospital surge to deny claims

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