Health Forward Foundation

Transition to KanCare Draws Relatively Few Concerns

Officials view sparse attendance at a Tuesday beneficiary meeting as a good sign

James Bart

KANSAS CITY, Kan. – Officials involved with the overhaul of the Kansas Medicaid program said they took the sparse attendance at beneficiary meetings in Kansas City, Kan., on Tuesday as a sign that enrollees have few concerns or questions about the transition to KanCare.

Identical sessions, one in the afternoon and the other in the evening, drew about 75 people combined. The room at the Jack Reardon Convention Center had more than 300 chairs. Most were empty.

That “indicates most consumers’ questions have been answered,” said James Bart, ombudsman for KanCare, which started Jan. 1. “I’d much rather have it be quiet.”

Implemented by Gov. Sam Brownback, the new program moved virtually all the state’s 380,000 Medicaid enrollees into health plans run by three of the nation’s largest managed-care companies: United HealthCare, Amerigroup and Sunflower State Health Plan, a subsidiary of Centene.

The Brownback administration estimates KanCare will save about $1 billion over five years, while also generating better medical outcomes through emphasis on coordinated care.

On notecards submitted anonymously, people at Tuesday’s meetings sought information on topics such as weight-loss programs offered by the managed-care companies and the availability of services from out-of-state providers.

Representatives of the three companies explained their weight-loss benefits and state officials said the companies’ networks included Missouri providers.

One person sought help getting a list of providers from one of the companies, saying two previous requests had gone unfulfilled.

Bart said the questions were fairly typical of the roughly 50 inquiries he is receiving each week.

Moderator Angela Taylor, a health plan manager for the Kansas Department of Health and Environment, stressed the importance of an April 4 deadline.

That’s the end of a grace period, known as the “continuity of care” window, though state officials have shown some flexibility on extending that 90-day transition period.

In general, though, after that time Medicaid enrollees could lose access to their established primary care physician, if that doctor is not in the plan to which the state has assigned the beneficiary.

Enrollees also have until April 4 to switch the plan they will use for the first year. State officials said each company had been assigned about a third of the state’s Medicaid enrollees when the program launched Jan. 1, but they said they did not have information on the number of enrollees who have that switched plans since then.

Taylor and representatives of the health insurance companies said plan members could see primary care providers other than the one listed on their insurance card, so long as the provider is in the plan’s network or has worked out a special arrangement to treat the patient.

“We don’t want you to freak out,” said Celia Ruiz, a community outreach specialist for UnitedHealthcare. “We want you to see your doctor, whether they are listed on your card or not.”

Taylor said state officials had tried to assign beneficiaries to the correct primary care physician based on past billing data. But she said they weren’t able to do that if the doctor was not in the network at the time the state issued the card. The assignments were made in November 2012 and some providers are still negotiating contracts with the insurance companies.

State officials have said the transition to KanCare has gone better than they expected. But some providers have complained about slow reimbursements from the managed-care companies.

Advocates for the developmentally disabled continue to argue that the state should exclude long-term services for that population from managed care. Those services include residential care and employment supports.

Jerry Van, of Kansas City, Kan., said he attended the afternoon session to learn more about the dental benefits for his 88-year-old mother, who is in a nursing home.

He said he planned to stop by his mother’s dentist office on the way home and see if the doctor was participating in KanCare. If not, he said, he’d have to find one that was.

He said he feared the transition might be bumpy. But, Van said, “I have not had to get on the phone and call around. I have had no problems with it.”

Janice Miles, of Kansas City, Kan., said she came to gather information on the three managed care companies to see if she should switch from Amerigroup.

She said she was happy with the company so far and likely would stay with it.

But Barbara Hill, of Kansas City, Kan., left the evening session unimpressed.

She said she needs about $5,000 worth of advanced dental work and the best advice she received was to attend an upcoming free dental clinic in Wichita.

Hill said the add-on services touted by the managed care companies, such as teeth whitening, wouldn’t take care of her dental problems.

“I don’t care about the bells and whistles,” she said, “just fix my teeth.”

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