State’s largest health care system says it will end contract with Coventry Cares

KentuckyOne Health, the state’s largest health-care system with almost 200 hospitals, physician groups, primary care centers and other agencies, is canceling its contracts with Coventry Cares, one of the state’s four Medicaid managed-care organizations. Terminations will be effective Nov. 1 for Jewish Hospital & St. Mary’s HealthCare and Saint Joseph Health System.

The decision came after Coventry sent a letter announcing it would terminate its contract July 18 with Our Lady of Peace hospital in Louisville. Coventry also terminated its contract with Taylor Regional Hospital in Campbellsville, another KentuckyOne facility, reports Valarie Honeycutt Spears for the Lexington Herald-Leader. She notes that Our Lady of Peace serves high-risk patients with intellectual disabilities. It is one of the largest private, non-profit psychiatric hospitals in the country.

“We feel Coventry Care’s actions will ultimately hinder and prevent the care our communities need and deserve,” said Barbara Mackovic, a KentuckyOne spokeswoman. “That is especially true when a plan would put our most vulnerable patient populations at Our Lady of Peace at risk.”

Issues with Coventry Cares have been mounting ever since it started administering Medicaid Nov. 1. The company, the state and Appalachian Regional Healthcare fought in court after Coventry threatened to terminate its contract. TCoventry temporarily extended its contract, but in in May the firm announced it would also end contracts with Baptist Healthcare System.

Managed care has saved the state money but has caused major headaches, including delayed provider payments and overly-burdensome preauthorizations. Coventry alleges “that it has too many high-risk patients and that the state needs to adjust the risk model so Coventry can receive more money for sicker patients,” Spears reported in May. (Read more)