Some worry that patient care will get shortchanged as Kentucky Medicaid moves to managed care

While moving Kentucky's Medicaid patients to managed care for will likely reduce costs to the taxpayers, patient care shouldn't be shortchaged in the effort to save a buck, Deb McGrath writes in an op-ed piece in The Courier-Journal.

"It is critical for quality patient care to always remain a priority," writes McGrath, executive director of the Epilepsy Foundation of Kentuckiana. "All citizens, including the 540,000 Kentuckians under the new managed care plans, deserve access to the best possible care recommended by their doctors."

McGrath is concerned about the "fail first" policy, also known as step therapy. "In this practice, the insurer will initially cover only the least costly medication in any drug class, forcing doctors to prescribe these medications first," she writes. "This is problematic because many times there are different medications that the physician feels would be the most effective treatment."

The policy can adversely affect Kentucky's 90,000 patients who have epilepsy, a disease that comprises 40 different seizure types and epileptic syndromes. "Fail first is not something a person with epilepsy wants to hear, especially when this policy can compromise their well-being and even their life," McGrath writes. "I urge Gov. Steve Beshear, the Cabinet for Health and Family Services, our state legislators and the new managed care organizations to keep patient care in mind as they get ready to implement this new system on Nov. 1." (Read more)