RENEE SHAW AND WE THANK YOU FOR SPENDING YOUR MONDAY EVENING WITH US.

MORE THAN A MILLION KENTUCKIANS ARE ON MEDICAID AT A HEFTY COST AND THE STATE WANTS TO FIND WAYS TO SAVE MONEY WHILE MAKING SURE THOSE WHO NEED HEALTHCARE CAN GET IT.

LAST WEEK THE KENTUCKY MEDICAID WORD IN FRANKFORT HEARD FROM MEDICAID EXPERTS TO LEARN ABOUT THE CHALLENGES AND OPPORTUNITIES OF NEW DELIVERY MODELS.

OUR EMILY SISK HAS DETAILS IN TONIGHT'S LEGISLATIVE UPDATE.

>> THE REAL ISSUE THAT WE NEED TO ADDRESS IS THE EXCESS COST OF HEALTHCARE.

>> DENNIS SMITH GAVE MEDICAID BOARD MEMBERS THAT ADVICE LAST WEEK.

SMITH HAS SPENT 40 YEARS WORKING ON MEDICAID THROUGHOUT THE COUNTRY.

HE SAID IN HIS EXPERIENCE IT OFTEN TAKES SOME EXTRA RESOURCES TO CUT DOWN ON WASTEFUL MEDICAID SPENDING.

>> IN ORDER TO REDUCE WASTE, FRAUD AND ABUSE, YOU HAVE TO ACTUALLY MAKE GREATER INVESTMENTS TO DO THAT.

>> SENATOR MEREDITH SAID IN HIS OPINION KENTUCKY'S MEDICAID PROGRAM DOESN'T NEED MORE MONEY IT NEEDS TO SPEND CURRENT FUNDS THE RIGHT WAY.

>> IT'S ALWAYS BEEN MY POSITION HOPE YOU CAN SUPPORT IT THERE'S ENOUGH MONEY IN THE SYSTEM TO TAKE CARE OF EVERY MAN, WOMAN AND CHILD IN THE COUNTRY IF WE SPEND IT THE RIGHT WAY, REDUCING THE ADMINISTRATIVE BURDEN.

>> THEY BOTH SAID ONE OF KENTUCKY'S BIGGEST HEALTHCARE PROBLEMS IS THE LACK OF RURAL ACCESS TO DOCTORS AND HOSPITALS.

>> I THINK IT IS A STARTING POINT YOU HAVE TO HAVE A STRONG PRIMARY CARE NETWORK AND IT DOESN'T EXIST IN RURAL KENTUCKY.

40S OF OUR POPULATION LIVES THERE AND 14% OF PRIMARY CARE PHYSICIANS ARE THERE.

I'M NOT SURE THERE'S HOPE FOR RURAL HEALTHCARE IN KENTUCKY.

>> THE HEALTHCARE EXPERTS SAID LOOMING FEDERAL CUTS TO MEDICAID WOBTD'S -- WON'T HELP THAT SITUATION.

THE FOUNDATION FOR A HEALTHY KENTUCKY SHARED IDEAS FOR NEW HEALTHCARE DELIVERRY MODELS THAT LOOK TO BRIDGE THE GAP OF SOCIAL SERVICES AND PHYSICAL HEALTH.

>> THESE MODELS EMBED ACCOUNTABILITY DIRECTLY INTO HOW CARE IS DELIVERED HOW COMMUNITIES INVEST IF AND IMPROVE HEALTH.

>> THE SENATOR DOUGLAS IS A PHYSICIAN IN CENTRAL KENTUCKY HE WAS CRITICAL OF THE PROPOSED HEALTHCARE MODELS SAYING PATIENTS NEED TO BE HELD ACCOUNTABLE MORE THAN THE COMMUNITY.

>> I'M LOOKING AT THE MODELS AND TRYING TO FIGURE OUT WHICH OF THESE CREATES PATIENT EXPECTATIONS, TRACKS PATIENT PARTICIPATION AND ADJUSTS BENEFITS BASED ON PATIENT'S APPLIANCE.

>> ALLISON SAID IN HER MODELS THERE IS MORE FOCUS ON IF THE COMMUNITY HAS THE RESOURCES NEEDED TO MAKE HEALTHY CHOICES.

SENATOR DOUGLAS STILL WAS NOT SATISFIED.

>> I'M TRYING TO FIND OUT WHICH SYSTEM SETS UP AN ACCOUNTABILITY, NOT OPPORTUNITY, I PUSHBACK A LOT AGAINST THAT WORD OPPORTUNITY.

BECAUSE WE CAN HAVE ALL THE OPPORTUNITY IN THE WORLD BUT IF WE DON'T GET OUT OF BED IT DOESN'T MATTER.

IT DOESN'T MATTER.

I'M TRYING TO FIGURE OUT WHICH ONE OF THESE ASK FOR MORE ACCOUNTABILITY FROM THOSE PEOPLE WHO ARE RECEIVING CARE WITHIN THE HEALTHCARE SYSTEM.

>> NEITHER.

>> OKAY.

THANK YOU.

>> ADAMS RESPONDED SAYING IN ORDER TO BUILD A HEALTHIER KENTUCKY, LEADERS WILL HAVE TO CONSIDER PATIENTS' SOCIAL NEEDS LIKE TRANSPORTATION AND HOUSING.

FOR "KENTUCKY EDITION" I'M EMILY SISK.

>> Renee: THANK YOU, EMILY.

STATE REPRESENTATIVE KEN FLEMING A CO-CHAIR OF THE COMMITTEE SAID THE GROUP IS WEIGHING ALL OPTIONS WHEN IT COMES TO MEDICAID DELIVERY MODELS THE COMMITTEE'S ROLE IS TO HEADACHE DISCUSSIONS TO THE GENERAL STEM R ASSEMBLY HOW TO PROCEED WITH