Why Not Expand Passport?

Have you read the recent position paper published by the Kentucky Chamber of Commerce? If you haven’t, you should take notice (you can find the position paper at the end of this piece). Kentucky business leaders are growing tired of the continuing upward spiral of Medicaid costs, at the expense of education and other priorities.

During my time with Jewish Hospital & St. Mary’s HealthCare, I served on the Board of Directors and Finance Committee of University Health Care. UHC operates Passport Health Plan. Passport is roughly ten years old.

My experience with Managed Medicaid didn’t start there though. During the late 1990s, John Morse served as Secretary of the Cabinet for Health Services under Governor Paul Patton. John was a proponent for converting Kentucky Medicaid to managed care. He and his staff divided the Commonwealth into eight regions and invited providers to submit proposals to establish managed care plans in each region. My firm assisted Region 8 with its proposal.

Only the Lexington and Louisville regions established Medicaid Managed Care Plans. And, only Passport, the Louisville plan, achieved long-term success. By any measure, Passport has been successful. It has improved access, reduced unnecessary utilization, bolstered the indigent care safety net and provided a more consistent approach to primary care.

Passport does all of that while at the same time providing a much more predictable budget line item for the Cabinet.

At the same time, the Medicaid program is an unmitigated disaster. Without going through the details, suffice to say that no one is happy with Medicaid. Providers struggle with Medicaid’s administrative failings and low payment. Patients have trouble with enrollment and access. And, governmental leaders watch as costs increase while funding for education (the lack thereof being the root cause for high Medicaid costs) is strapped and fail to make any substantive changes.

So why doesn’t the Cabinet pursue a Medicaid managed care approach strategy state-wide? I am having trouble answering that question. What do you think?

The Kentucky Chamber’s position may be found here:

Kentucky Chamber of Commerce Medicaid Proposal


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