Author: P Hasselbacher

Is Private Medical Insurance Really Less Intrusive than Government?

Is Jennie Stewart Hospital being treated fairly or not?

We have written about the conflicts between medical providers and insurance companies in these pages before. The recent spate of lawsuits and public recriminations related to Medicaid Managed Care in Kentucky give particular insight into the posturing and dueling over who gets to keep how much of our tax and insurance premium money. What is usually left out over these increasingly pubic spats in the magical world of medical pricing is just how many dollars are involved. Continue reading “Is Private Medical Insurance Really Less Intrusive than Government?”

UofL’s Ramsey Urges Board Members and Officers to Lobby over QCCT Fund

My advice to the Mayor and Metro Council.

I received a copy of a message University of Louisville President Jim Ramsey sent today to a star-studded list of politically connected board members, University executives, at least one employee of Louisville Metro government, and other folks of the sort that regularly get invited to UofL events.  It urges these high-profile individuals to use whatever political influence they have to lobby decision-makers over Derby Week with a goal of convincing the Louisville Metro Council and Mayor’s office to fully fund the QCCT fund that supports some of the non-compensated care provided by University Hospital. Here it is. Continue reading “UofL’s Ramsey Urges Board Members and Officers to Lobby over QCCT Fund”

Another Turnover of Deans at the University of Louisville.

Enrollment Management at UofL.

I am getting  a lot of new material from Insider Louisville. I envy their information network! (Hint. Hint.) Friday’s content included notice of the fact that following a five-year tenure, Dean Jim Chen of the University of Louisville’s Brandeis School of Law had left his position. This appeared to be a surprise to some because, among other achievements, he had been very successful in raising both money and the status of the Law School. Dean Chen will take a year of administrative leave and retain his faculty appointment. Dean Chen is a lot younger than me. If this was his career decision, I congratulate him and wish him well. However, in the secretive world of intrigue that is the University of Louisville, my default skepticism stirs. Continue reading “Another Turnover of Deans at the University of Louisville.”

Medicaid Managed Care Lawsuits: Further Thoughts

Are different MCOs treated differently by the state?

Terry Boyd at Insider Louisville has been out front in reporting on the emerging lawsuits by at least one major Medicaid provider against at least two Medicaid Managed Care Organizations (MCOs) that are handling Medicaid managed care for the Commonwealth. Thank you! I have already expressed my opinion that these suits are like canaries in the cage telling us that something is very wrong with the health of Medicaid in the state and by implication, for the health of Medicaid beneficiaries, medical providers, and those who finance the system. Keep it up!

I am still confused by the nature and details of the claim by Coventry that they were treated differently than at least one other MCO by the state in terms of their requirement to have Appalachian Regional Healthcare (AHS) in their provider network. (I too assumed that the “other” was Kentucky Spirit, but Mr. Nolan of Coventry seems careful not to name the other organization.) From their lawsuit against Kentucky Spirit (KS), it appears that ARH opted not to sign a full provider contract with KS that would have required it to accept the payment rates of KS as well as other contractual agreements. That would make ARH an out-of-network provider for KS. Despite this, KS continued to authorize and therefore agreed to pay for at least some patient services from ARH. Continue reading “Medicaid Managed Care Lawsuits: Further Thoughts”