Improving Health Care Quality and Access Throughout Kentucky
Case Study Details:
Expertise
Market
Kentucky’s University Directed Payment Program
Sellers Dorsey collaborated with a long-standing provider coalition, including the University of Louisville School of Medicine and University of Louisville Health (collectively “UofL”), as well as the Norton Children’s Medical Group (NCMG) and University of Kentucky (UK), to implement a directed payment program (DPP). By raising Medicaid funding levels from the Medicare equivalent to the average commercial rate (ACR), the program has expanded access and improved patient outcomes for both UofL Health, one of Kentucky’s most significant health systems, and NCMG, the area’s largest pediatric provider.
Program Focus
This program is critical to the health of Kentucky’s future generations due to providing primary and vital pediatric specialty care to one in five Kentucky Medicaid child beneficiaries. The Medicaid managed care program supports statewide access to UofL’s health care system – a physician group of over 700 providers with 80 subspecialties at 200 practice locations.
The team has worked with the coalition over three program years to:
- Preserve and enhance the existing supplemental funding stream of UofL.
- Achieve double-digit improvement on several of 14 equality measures.
- Qualify providers for 100% of the at-risk quality performance-based payments.
Emerging Impacts
The funding made possible through this DPP is having the following impacts in Kentucky:
Prevented the closure of a failing health system and critical hospital in the state
Improved access by opening an urgent care clinic in a medically underserved neighborhood.
Increased well child visits by 56% for children one to 15 months.
Exceeded the national 90% benchmark for diabetes care.
Changed workflows and programs to increase focus on preventive care metrics
Enhanced staffing levels for care coordination and engagement.
More information about results available by contacting Sellers Dorsey
Program Creation
Sellers Dorsey worked closely with the coalition from strategy development through program execution to:
- Design a transformative, value-based program.
- Educate key leaders on innovative methodologies and approaches.
- Increase the hospital payment methodology to the commercial equivalent for all coalition members.
- Developed relationships with key coalition stakeholders, State officials, and vendors.
- Ensured program participation for all entities of UofL’s acquisition of the Kentucky One system.
- Secure CMS approval for a multiyear program.
- Facilitate implementation.
Client Insights
“I’m so pleased with all the success we have enjoyed over the past few years and know we would not be where we are without the help of Sellers Dorsey. I am very appreciative of that help and the relationship we have developed.”
– Jerry Johnson, Chief of Staff to the Executive Vice President for Health Affairs, University of Louisville
“The success we’ve been able to achieve has been in partnership with Sellers Dorsey. They’ve made a tremendous impact, and we are thankful for the relationship we’ve been able to grow over the years.”
– Shelly Gast, System Vice President Managed Care & Payor Strategy, Norton Healthcare
