Questions loom over Kansas Medicaid plan
The Kansas City Star
The people who deliver medical care to Kansans are expressing growing alarm as Gov. Sam Brownback’s administration moves full speed ahead on its sweeping overhaul of the state’s Medicaid program.
The state has contracted with three managed care insurance companies, which are expected to coordinate health care for nearly 400,000 Kansans, including the developmentally disabled and indigent elderly populations.
The transformation from a mostly government-run system to a privately managed one is scheduled for Jan. 1. But at a meeting of the Legislature’s Joint Budget Committee last week, stakeholders representing hospitals, nursing homes and disabled citizens said they had been unable to obtain satisfactory information about billing procedures, record-keeping requirements and quality control issues.
Groups that have provided health care in Kansas for years said they are being asked to sign contracts with the insurance companies without completely understanding what will be expected of them.
“I don’t see how in the world they’re going to be able to roll out a major change of this magnitude and have it go smoothly,” said Sen. John Vratil, a Republican from Leawood, who attended the meeting.
Groups seeking information are being stymied by secrecy on the part of officials and by the complexity of what is going on.
The Johnson County Commission and Johnson County Developmental Supports, the agency that serves the developmentally disabled, recently sought information on how much the three insurance companies chosen to run the program will collect in profit or administrative fees.
State officials initially told them that information was “proprietary and confidential,” and not to be shared, said Maury Thompson, director of Johnson County Developmental Supports.
The administration backed down after the county commission filed an open records request. But the documents provided are intricate and highly technical and will require expertise to interpret.
State officials should provide in plain language the answer to this important question: How much of the money the managed care companies will receive from the state will be spent on profit and expenses other than medical care to patients? And the state officials must work harder to answer questions from the medical providers who will be the ones counted on to make the program work.
At the budget committee meeting, Shawn Sullivan, secretary for the Department for Aging and Disability Services, said senior officials will decide by Oct. 19 whether the new system was ready to go forward.
The Brownback administration’s move toward privatized heath care for the Medicaid population has been characterized from the start by an overconfidence bordering on hubris. That has to give way — quickly — to a willingness to take a cold, hard look at whether the mammoth changes being contemplated can succeed in a short time frame.