Princess Health andKentucky re-bidding Medicaid managed care contracts to address complaints of patients, advocates and health-care providers.Princessiccia

Princess Health andKentucky re-bidding Medicaid managed care contracts to address complaints of patients, advocates and health-care providers.Princessiccia

health insurance managed care Medicaid state government

Gusty 14:17 Add Comment

By Melissa Patrick
Kentucky Health News

State officials are re-bidding Medicaid managed-care contracts that cover more than 1.1 million Kentuckians. The news came as a delight and surprise to many health-care providers and patient advocates.

�I was both stunned and thrilled by the announcement. I did not know it was coming,� Sheila Schuster, a Louisville mental-health advocate, told Tom Loftus of The Courier-Journal. �A number of the changes that they say will be part of the new contracts are things those of us in the behavioral health community have brought up time and time again.�

Kentucky changed to Medicaid managed care from a traditional fee-for-service model in 2011 to fill a projected budget overrun of $166 million. Health Secretary Audrey Haynes said in a news release that doing so has "saved Kentucky taxpayers more than $1.3 billion in state and federal funds" and had also improved the delivery of health care to the Medicaid population.

"However, after several years of experience, we determined it was time to retool, rebid and strengthen the contracts to appropriately address concerns expressed by advocates and healthcare providers," Haynes said.

The transition to managed care has been met with consistent complaints from both patients and providers, despite efforts of the cabinet to work through the issues and keep the channels of communication open between providers, the cabinet and the managed-care organizations.

Two passionately debated bills in the recent legislative session challenged some practices of the current MCOs: one seeking an appeals process for denial of payments and the other removing a cap of "triage fees" for emergency-room services that MCOs later deem not to be emergencies.

Both issues have been challenging to the financial health of rural hospitals. State Auditor Adam Edelen addressed many such issues in a recent report on the financial health of rural hospitals.

�We are pleased to see the cabinet taking steps to improve and strengthen managed care contracts, many of which we recommended in our recent report on the financial strength of rural hospitals,�Edelen told Insider Louisville.

Some requirements for the new contracts include: required statewide coverage; standardized rules among the MCOs; improved administrative processes; increased oversight of claim denials; continued expansion of behavioral health services; incentives for MCOs to work with Medicaid patients to decrease emergency-room use and improve their health; and increased penalties to assure contract compliance. Click here for the Cabinet for Health and Family Services' complete Request for Proposal.

�I�d like to say that they heard the voice of the people,� Schuster told Insider Louisville.�If you look at the Medicaid Advisory Council, those meeting are every two months and it�s the same litany of complaints and concerns every darned time with no response. The only thing I can think of is it�s a gesture by this outgoing administration to get things right so that regardless of who comes in next year, there are strong contracts in place. I applaud them for it, and I�m stunned.�

The current contracts with Anthem, Aetna's Coventry Cares, Humana's CareSource , Passport and Wellcare expire on June 30, 2015 and proposals for the new contracts are due by May 5. The statewide contracts will be awarded to multiple MCOs for a one-year period with four, one-year renewal option, according to the news release.

Princess Health andKentucky's suicide rate is above the national average; experts say we need to ignore the stigma and become educated about it.Princessiccia

Princess Health andKentucky's suicide rate is above the national average; experts say we need to ignore the stigma and become educated about it.Princessiccia

newspapers suicide

Gusty 10:32 Add Comment

Kentucky's suicide rate is higher than the national average, and an expert says we must create an open dialogue about it and provide more education if we want this rate to decrease, Kat Russell reports for The Paducah Sun.

"People commit suicide when they see no way out from whatever the situation is," Dr. Laurie Ballew, medical director at Paducah's Lourdes Behavioral Health Institute, told Russell. "Usually people feel hopeless, they see no light at the end of the tunnel, and that hopelessness is a key factor in someone following through with the act of killing themselves."

Russell did an in-depth look at suicide in McCracken County, where the newspaper and its owner, Paxton Media Group, are based. "McCracken County is ranked 13th in the state as far as suicide, so if you take into consideration all of the (120) counties in Kentucky, we're pretty high," Ballew said. Click here to find out where your county ranks.

Kentucky has 15.5 suicides per 100,000 people, compared to 12.5 nationwide. It is the 10th leading cause of death in Kentucky and the second leading cause of death in people 15 to 34, according to the according to the federal Centers for Disease Control and Prevention, Russell reports.

McCracken County Sheriff Jon Hayden told Russell that his department investigated 31 suicides in each of the last two years and five so far this year. The Paducah Police Department reported 31 suicides in 2013 and 35 in 2014, and six suicides this year. The local 911 dispatch center told Russell that it had fielded more than 540 calls threatening suicide and more than 130 attempted suicides since Jan. 1, 2013.

"We get calls multiple times per week, threatening suicide either with medication or a weapon of some sort," Hayden said, noting that most of the calls do not result in suicide and the individual usually gets the help they need.

WebMD lists these warning signs of suicide, which are especially concerning if a person has attempted suicide in the past:

• Always talking or thinking about death
• Clinical depression that gets worse
• Having a "death wish," tempting fate by taking risks that could lead to death.
• Losing interest in things one used to care about
• Making comments about being hopeless, helpless, or worthless
• Putting affairs in order, tying up loose ends, changing a will
• Saying things like "it would be better if I wasn't here" or "I want out"
• Sudden, unexpected switch from being very sad to being very calm or appearing to be happy
• Talking about suicide or killing one's self
• Visiting or calling people to say goodbye

Drug and alcohol abuse also can be factors, Ballew told Russell. "What do those things do? They decrease our inhibition, they decrease our filter that tells us 'Oh no, you don't want to do that.'"

Ballew told Russell if a person's behavior changes are milder, "sometimes showing that person support and compassion can alleviate some of his or her suffering and encourage them to get help," but it is important to seek medical attention for "severe cases."

"If you have an individual who just gets more and more depressed, who won't get out of bed or gets to the point where they can't get out of bed, then you (should) call an ambulance or get them to a hospital and have them admitted," Ballew said, stressing the importance of education and open discussion.

"Emotional illness can hit anybody," she told Russell. "We're all humans. ... Anybody can feel hopeless or helpless at any time. If we could reduce the stigma that is attached to depression and mental illness and suicide, then I think people who are suffering might see that maybe there is some hope. But the only way to prevent something is to be educated about it."

Princess Health andPilot salad bar will determine whether other Jefferson Co. schools follow suit in bid to increase students' veggie and fruit intake.Princessiccia

Princess Health andPilot salad bar will determine whether other Jefferson Co. schools follow suit in bid to increase students' veggie and fruit intake.Princessiccia

fruit nutrition school lunch schools vegetables

Gusty 09:45 Add Comment

The Jefferson County Public School system is pilot-testing a salad bar at Atherton High School to entice students to eat more vegetables and fruits, a goal of the new federal nutrition standards, Allison Ross reports for The Courier-Journal.

Photo from TheProduceMom.com

"We're always looking for new ideas to increase participation or attract students to come through the serving line," Terina Edington, assistant director for nutrition services, told Ross.

Many of Kentucky's children are falling far short of the daily recommended four and a half cups or more of fruits and vegetables, a shortcoming that one study says will contribute to early heart disease. The Centers for Disease Control and Prevention 2013 State Indicator Report on Fruits and Vegetables found that only 50 percent of Kentucky adolescents reported eating fruit and 43 percent reported eating vegetables with a median intake of one time per day for both.

Salad bars were once common in Jefferson County schools, but concerns about portion control and contamination concerns caused them to "slowly disappear," Edington told Ross. Many schools across the country continue to "remain leery" of adding salad bars because of such health concerns, Ross writes.

This trial will help the district determine whether it will put salad bars in other schools. Cafeteria modifications for the salad bar at Atherton cost $400, Ross reports.

A push for schools to add more salad bars has been led by First Lady Michelle Obama's "Let's Move" initiative, which co-sponsors a "Salad Bars 2 Schools" program that has donated more than 4,000 salad bars to schools, Ross reports. "A 2014 evaluation of that program found that 57 percent of participating schools saw an increase in student participation in school lunch, and 78 percent reported buying more fruits and vegetables."

The school's Facebook page said that the salad bar would have diced ham, turkey breast, fajita chicken strips, cucumbers, baby spinach, radishes and four types of dressings, with the lettuce and meat portions pre-measured, while the other ingredients will be self-serve.

Atherton High parent Lynn Greene told Ross that she is "thrilled my child has a healthy option," saying she hopes other schools will also get salad bars.

Princess Health andProposals sought for research of Appalachian 'bright spots' where health is better than socioeconomic factors would indicate.Princessiccia

Princess Health andProposals sought for research of Appalachian 'bright spots' where health is better than socioeconomic factors would indicate.Princessiccia

Appalachia county health Foundation for a Healthy Kentucky health health rankings health status overall health status research

Gusty 15:58 Add Comment

A three-year research project to determine factors that can support a culture of health in Appalachia and whether that knowledge can be translated into actions that address the region's health disparities has released its Request for Proposal to invite proposals from qualified research teams and consultants who would like to work on this project.

The project,�Creating a Culture of Health in Appalachia: Disparities and Bright Spots,� is sponsored by the Appalachian Regional Commission, the Robert Wood Johnson Foundation and the Foundation for a Healthy Kentucky and will run through the end of 2017.

The research for this project will identify Appalachian �bright spots,� where health outcomes are better than would be expected based on unemployment and poverty rates and other community factors, and try to figure out why. Researchesr will also try to determine why health outcomes in some communities are not as good as would be expected.

The request for proposals offers detailed guidelines for submissions, which are due June 8. Applicants are encouraged to register for a webinar, detailed on the RFP, to be held May 7 at 10 a.m. EDT. Click here for more information.

Princess Health and Food Reward Friday. Princessiccia

Princess Health and Food Reward Friday. Princessiccia

Gusty 03:00 Add Comment

This week's "lucky" winner... bacon fried Oreos!!

Read more �

Princess Health andMount Sterling follows lead of another KentuckyOne Health hospital, in Bardstown, to host monthly 'Walk With a Doc'.Princessiccia

Princess Health andMount Sterling follows lead of another KentuckyOne Health hospital, in Bardstown, to host monthly 'Walk With a Doc'.Princessiccia

exercise health literacy physical activity physical fitness physical inactivity physicians walking

Gusty 18:33 Add Comment

Saint Joseph Mount Sterling is the second KentuckyOne Health hospital to host monthly "Walk With a Doc" events as part of a nationwide program that promotes walking as a great way to improve your health, while at the same time offering a place to get to know your local physicians in an informal setting as you walk together. The program also offers a complimentary health screenings at the event, says a news release from KentuckyOne Health.

Flaget Memorial Hospital in Bardstown, also part of KentuckyOne Health, began its "Walk With a Doc" program in March.

"According to America Walks, brisk walking has been shown to reduce body fat, lower blood pressure, increase high-density lipoprotein and even reduce risks of bone fracture. Not only that, it is also associated with lower mortality rates from cardiovascular disease and cancer," says the release.

The Mount Sterling walks begin at 9 a.m. on Saturday, April 25 at Easy Walker Park, located at 1395 Osborne Rd. For more information call 859-497-5556.

Princess Health andStranger donates kidney after knowing recipient 5 minutes; could boost living kidney donations, which have better odds.Princessiccia

Princess Health andStranger donates kidney after knowing recipient 5 minutes; could boost living kidney donations, which have better odds.Princessiccia

kidney transplant organ donation

Gusty 09:06 Add Comment

Two strangers were randomly asked to take part in a five-minute demonstration of living art. It led to one of them donating a kidney to the other, Bailey Loosemore reports for The Courier-Journal.

The  idea of the demonstration, produced by Transylvania University faculty members for the 2013 IdeaFestival, was to ask two strangers to talk for five minutes, and then post a "burning question" on Twitter.

After five minutes of discussion, a University of Louisville employee, identified only as Kathy, told Loosemore that she thought about how she wanted to do something important and  decided her burning question was, "What's next?"

Jackie Thomas (C-J photo by Alton Strupp)

Jackie Thomas, a retired teacher and dialysis patient since 2011, was also wondering "What's next?" She had recently been placed on a kidney transplant list, but had already started looking into living donations, in which a healthy person volunteers to donate one of their organs, because the wait is so long to get a kidney from a deceased donor, Loosemore writes.

But Thomas said she wasn't sure how she was going to ask someone for a kidney until Kathy asked, "What's next?" She thought "Wow, that is really a powerful question," and replied with a burning question for Kathy's Twitter feed: "Would you like to donate a kidney to me?"

Kathy said yes. "I think my question about what's next was kind of in my head, and this was kind of an answer. OK, I can donate a kidney," she told Loosemore. She asked that her last name not be revealed because she did not want the focus to be on her.

The offer left Thomas speechless, Loosemore reports: "I said to her, 'I've only known you for five minutes, and you're going to give me a kidney?' She said 'Yeah,' and she looked really serious. ... So I thought, 'Here is the answer to my prayers, maybe.'"

Because living donations are all voluntary, Thomas did not know for certain if the transplant was really going to happen until the day of the surgery, April 8, 2014.

Kathy, who told Loosemore that she meets Thomas for lunch at least once a month, said she has no regrets.

"It's a really personal decision," she told Loosemore. "I'm not going to go out and say everybody should donate a kidney, but I think people should know for a healthy person, it's relatively risk-free and it's not that painful. And if they're really interested in doing something that makes a big difference in someone's life, educate themselves, but definitely think about donating a kidney, because it's not that bad."

Loosemore reports that more than 100,000 Americans are on waiting lists for kidneys and that in 2014, living donations made up only 32 percent of transplanted kidneys -- and only 25 percent in Kentucky, according to data from the Organ Procurement and Transplantation Network. So far in Kentucky this year, there have been 13 kidney transplants, eight from deceased donors and five from living donors; last year, there were 109 from deceased donors and 36 from living.

"The benefits of living kidney donations far outweigh the risks, with living kidneys lasting twice as long as those from deceased donors and the surgeries causing little pain," Loosemore writes, quoting Dr. Mike Hughes, a transplant surgeon who works for University of Louisville Physicians and operates at Jewish Hospital � the only one in Louisville that does transplants.

Jewish Hospital continues to promote its donor champion program, in which family members are asked to request kidneys for recipients who may feel too uncomfortable to do so, and plans to hold an informational forum later this year, in an effort to raise awareness, Loosemore reports.

The forum and the donor-champion program "will help identify barriers that lead to fewer donations and will help encourage those who want to take the next step," Loosemore writes. Jewish Hospital's transplant director, Laurie Oliver, told her that living donations will become "the standard of care at some point in the future, if we can do that."

Click here to learn more about living kidney donation from the National Kidney Foundation. To learn how to donate a kidney through Jewish Hospital, call 502-586-4900.