Managed Care Coming to Medicaid
Posted November 10, 2011 by Mandy Smith in Programs and Services
Yesterday Gov. Sam Brownback and Lt. Gov. Jeff Colyer unveiled sweeping changes to the Kansas Medicaid program. These changes were a part of the Governor’s “Roadmap” and took on one of the three big areas he wanted to tackle along with KPERS and Education.
Beginning in January of 2013 all Medicaid recipients will be under Managed Care plans. The administration foresees “at least 3” Managed Care organizations running the state plan they have named, KanCare.
The goals for the new program are to reduce cost, by as much as $853 million (all funds) over the next five years, and to improve care quality and outcomes for beneficiaries. KanCare places a great emphasis on treating a person as a whole by using care coordination and person centered planning by the managed care organization.
What does this mean for Kansans with disabilities? It means that for-profit corporations will now be managing your care. States have been moving more and more towards a managed care model for Medicaid and managed care has been shown to reduce costs.
The way that managed care programs accomplish this is by cutting down on very expensive services such as hospital admissions by utilizing preventative care and wellness programs or limiting what services are covered or considered “necessary”.
Kansas’ foray into Medicaid managed care will start with 3 year contracts with the managed care organizations which could be a cause for concern. There is no “trial” run it will either work, or it won’t. Of course, because the corporations running the program are accountable to their shareholders to make a profit, the money spent on Medicaid in Kansas will have to include a profit margin for the managed care organizations.
I am including links to the KanCare FAQ, the KanCare Executive Statement, and the Medicaid Reform Plan Press Release.
Medicaid Reform Plan Press Release
The RFPs were issued yesterday to companies interested in managing Kansas Medicaid and are due back to SRS in January 2012.
Along with Medicaid Reform is some pretty major agency shuffling. Kansas Dept. of Aging will become Kansas Department for Aging and Human Services and fold in services for the mentally ill, all 5 state hospitals for the mentally ill and developmentally disabled as well as the Home and Community Based Services waivers for Kansans with disabilities. The Kansas Dept. of Health and Environment (KDHE) will oversee the Medicaid contracts and finances.
SRS will be renamed Department for Children and Family Services and focus solely on programs for children and families. They will keep Adult Protective Services and will fold in Family Preservation programs that are currently with KDHE and some prevention programs from the Juvenile Justice Authority.
As my previous blog post stated, changes are coming to the disability community in Kansas and it is up to us to make certain that we are not just passively accepting what is handed to us. We need to make our voices and our needs heard. We must demand that any changes made preserve our independence, our ability to choose, and include our input.
The Resource Center for Independent Living will continue to update you as we can about the upcoming Medicaid reform and the soon-to-begin Legislative Session.
