A CONCURRENT RESOLUTION directing the Legislative Research Commission to conduct a feasibility study for an Accountable Communities for Health Medicaid delivery model pilot project.
SCR 9 is a concurrent resolution directing the Legislative Research Commission to hire a vendor to conduct a feasibility study for an Accountable Communities for Health (ACH) Medicaid delivery model pilot project. The resolution argues that Kentucky’s current Medicaid managed care system has produced rising costs and worsening health outcomes, especially in rural areas, and that a more coordinated, community-based, value-driven model could improve care while reducing spending. It frames ACH, accountable care organizations, and related models as alternatives that integrate physical, behavioral, and social supports and emphasize prevention, shared savings, and accountability for outcomes.
The study would examine how similar Medicaid delivery models operate in other states, what governance structure might work in Kentucky, what regions and partners could support a pilot, and what data-sharing and interoperability infrastructure would be needed. It also asks for analysis of financing options, including whether current per-member-per-month capitation payments to managed care organizations could be redirected to the pilot, and whether a nonprofit mutual insurance company could administer claims and provider payments. The resolution sets a target for the study report to be delivered by November 1, 2026, for review by legislative committees and the Medicaid Oversight and Advisory Board, and it names a potential pilot as the “20 by 30 Accountable Care Pilot Project.”
SCR 9 does not itself change Medicaid eligibility, benefits, or provider reimbursement statutes; instead, it creates a legislative study directive through the Legislative Research Commission. Its practical effect is to initiate a formal review of whether Kentucky could move from its current managed care structure toward an accountable care or accountable communities for health model, with particular attention to rural regions and existing area development districts. The resolution may influence future appropriations, Medicaid oversight, and procurement decisions by generating recommendations on governance, financing, data systems, and implementation pathways.
The bill advanced with unanimous support in both chambers, indicating strong bipartisan agreement on at least the need to study alternatives to the current Medicaid delivery model. The resolution’s findings reflect a critical view of managed care and a favorable view of community-based accountable care approaches, and the votes suggest lawmakers were receptive to exploring those ideas. The absence of recorded opposition in the floor votes points to broad legislative interest in examining cost containment and health outcome improvements.
The main points of contention are embedded in the resolution’s policy framing rather than in recorded floor debate. The bill sharply criticizes for-profit Medicaid managed care organizations, suggesting their profit incentives contribute to rising program costs, and it raises the possibility of diverting capitation payments away from existing MCOs. Those themes could be controversial for managed care companies, insurers, and stakeholders invested in the current system. Another likely area of debate is whether Kentucky has the data infrastructure, regional capacity, and financing stability to implement an ACH pilot, especially in rural areas and across multiple agencies and providers.