Medicaid managed care findings

The final report is now available from a three year study on the impact of Kentucky’s transition to Medicaid managed care. Foundation for a Healthy Kentucky contracted with the Urban Institute, based in Washington, DC, to assess the impact Medicaid managed care on healthcare access, quality, costs, and health outcomes.


“Our aim was to foster candid conversations about this important transition and to use what has been learned to support more effective functioning of Medicaid managed care in the Commonwealth” said Susan Zepeda, president/CEO, Foundation for a Healthy Kentucky. “The study, conducted by the respected Urban Institute, is one of few in the nation to observe such a transition as it unfolded – permitting policymakers to benefit in real time from information on patients’ experience with this new way of delivering care.”


In 2011, Kentucky expanded the use of managed care in its Medicaid program, bringing it more in line with Medicaid programs in other states, where managed care has been the norm. This evaluation finds that the implementation of managed care in Kentucky’s Medicaid program was associated with reductions in Medicaid spending and service use for both adults and children covered under Medicaid for a full year or more.


Genevieve Kenny, co-director of the Urban Institute’s Health Policy Center and lead researcher for this study, notes “these findings indicate both potential improvements and declines in care through 2013 under Medicaid managed care relative to the prior fee-for-service delivery system. However, because 2014 was a time of substantial change in Kentucky’s Medicaid program and in the behavioral health system, the measures tracked in this report may have changed since 2013. Moving forward, these results suggest the need for continued monitoring of enrollee utilization patterns.”


Two separate progress reports were presented to legislators during the study period: An initial baseline report and a second year report which included an update on the implementation process and presented findings from interviews, review of relevant documents, and ten focus groups representing four types of Medicaid managed care members conducted in three regions of the state (Lexington, Hazard, and Madisonville). The complete final report is at