Lexington Herald-Leader

December 20, 2003

 

State says HMO for inmates saves 40%

UK MONITORS PROJECT TO CUT HEALTH COSTS

 

By Karla Ward

HERALD-LEADER STAFF WRITER

 

The state’s prison inmates now have their own HMO, and its saving the state about 40 percent on the fees paid to doctors and hospitals for providing care, officials said.

 

In addition to saving the state money, the project, called the Kentucky Corections Health Services Network, is intended to provide better care to the prison population.

 

Under the arrangement, started in October, the state’s 16,000 inmates will continue to receive primary care services at their correctional institutions.

 

But if they need specialized care or hospitalization, they’ll be sent to a provider within the new statewide network of doctors and hospitals.

 

If the medical procedure is complicated, if will have to be approved first.

 

Previously, each prison arranged for inmates’ care with little overall coordination.

 

The network was set up and will be managed by a private health care management firm hired by the state.  It will be monitored by Phillip Roeder, a political science professor at the University of Kentucky, through an agreement between the corrections department and UK.

 

Providers will be paid for the care they give prisoners at the same rate they would be paid as part of the CHA Health network.  CHA is a for-profit insurance company owned primarily by UK.

 

Before, the state was paying more than the “usual and customary” rate for health care services and much more than the network rate, said John Tarrant, director of dental services for the Department of Corrections.

 

“Our costs were getting away from us,” Tarrant said.

 

The state’s annual budget for specialized and hospital care for inmates is $15 million.

 

The increased management has also resulted in shorter hospital stays, Tarrant said.

 

He said inmates will benefit from having a set network of providers.

 

“They receive the care that’s consistent with a community standard,” he said.

 

Roeder said UK also hopes to tap into the research potential the new arrangement offers.

 

Just about every pathology you can imagine, those prisoners have,” he said.

 

Tarrant said the studies will only involve looking at the long-term outcomes of treatments that are already approved.