Here’s hoping that KanCare will work as promised – because the well-being of more than 375,000 low-income Kansans, as well as doctors and hospitals, depends on it.
Kansas received the federal go-ahead last week to launch its reform of Medicaid. Starting Jan. 1, three out-of-state insurance companies will manage the health care program. The Brownback administration contends that by better coordinating care, the state will save money while producing better health outcomes.
In announcing the approval, Gov. Sam Brownback said that KanCare is “truly what Kansans want and need.”
The program may be what the state needs to help control costs, but whether it is what Kansans “want” is debatable.
Public comments posted online and made during a conference call last month sponsored by the federal Centers for Medicare and Medicaid Services were overwhelmingly critical of the reform. And because of strong opposition, the Brownback administration agreed not to include Kansans with developmental disabilities in the plan until 2014.
A key concern is that the insurance companies could have an incentive to limit or discourage care – because they make money when the state spends less. When case managers work for the insurance companies, whose interests will be their priority: the clients or their employer?
Kansans who will be part of KanCare also have raised concerns about the limited number of doctors and hospitals that have signed up thus far for the program.
Another concern is that other states with similar programs have had problems with insurance companies committing fraud and not promptly reimbursing doctors and hospitals.
Kansas officials say that they have learned from other states and created safeguards and incentives to protect against such problems. But doubts remain.
For example, can the state really save $1 billion over five years, as the Brownback administration projected, without cutting provider rates, eligibility or services?
And does the administration really have the management expertise to prevent major problems? Frankly, its track record doesn’t inspire much confidence.
Despite these doubts and concerns, KanCare is happening – in less than three weeks. Ready or not.