Given all the controversy about KanCare – Kansas’ privatized Medicaid program – it would be reasonable to expect big crowds at public hearings about renewing the program.
But that wasn’t the case Wednesday when relative handfuls of health care providers and consumers turned out in Topeka for the first in a series of forums scheduled across the state.
The sparse turnout disappointed state officials and legislators who attended.
Rep. Brenda Dietrich, a Topeka Republican who attended an afternoon session for providers and another in the evening for consumers, said officials at the state agencies organizing the forums need to do more to publicize remaining meetings, which are scheduled through the end of the month.
“I didn’t see it in the newspaper, and I’m a Topeka resident,” Dietrich said. “The only reason I found out about it was one of the lobbyists for individuals with disabilities sent me information about it.”
State officials are conducting the meetings to gather input to help them finalize the blueprint for what they’re calling KanCare 2.0 — the next phase of the program.
“The purpose (of the forums) is to hear back from the beneficiaries who are receiving services and the providers who are providing services in KanCare to make sure that we can make it the best possible program for the people we serve,” said Susan Mosier, secretary of the Kansas Department of Health and Environment, the state’s lead Medicaid agency.
Republican Gov. Sam Brownback launched KanCare in January 2013, contracting with three private, for-profit insurance companies to manage the care provided to Kansans in Medicaid.
Currently the program serves about 440,000 Kansans, mostly children in low-income families, people with disabilities and low-income elderly Kansans who need nursing home care.
Since the switch to managed care, there have been ongoing complaints from doctors, hospitals and other providers about increased red tape and payment delays. Consumers, particularly those with developmental and physical disabilities, also have raised concerns about reductions in service.
Weary of complaints from constituents, the Legislature passed a bill this session requiring the state and the three insurance companies to step up their efforts to make the program more efficient. The bill also established a process aimed at more quickly resolving treatment and payment disputes.
The problems cited by providers and consumers, exacerbated by a cut in provider reimbursement rates, prompted the Centers for Medicare and Medicaid Services to deny a state request to extend KanCare by one year to provide more time to finalize plans for the next iteration of the program.
That decision, made in January by outgoing officials in the Obama administration, was reversed in May by Trump administration officials, but only after the state implemented a corrective action plan.
Despite those problems, Mosier said KanCare has slowed the growth in Medicaid costs by more than $1 billion and, according to a recent independent review, improved the health of Kansans served by the program.
“We are continuing to progress and improve in multiple areas,” Mosier said.
Rep. Dennis “Boog” Highberger, a Lawrence Democrat, attended one of the Topeka forums because he remains concerned about KanCare. He said the private companies operating the program have a financial incentive to deny care.
“They get a fixed payment, so the less they can spend providing services the more can go to shareholders,” Highberger said.
Despite his concerns, Highberger said he hopes that the public feedback provided at upcoming forums helps state officials improve the program going forward.
Jim McLean is managing director of the Kansas News Service, a collaboration of KCUR, Kansas Public Radio and KMUW covering health, education and politics. You can reach him on Twitter @jmcleanks. Kansas News Service stories and photos may be republished at no cost with proper attribution and a link back to kcur.org.