Is KanCare working?

The goal of properly caring for vulnerable Kansans shouldn’t be partisan.
The goal of properly caring for vulnerable Kansans shouldn’t be partisan.

There may be no turning back on KanCare, the Brownback administration’s privatization of what had been a fiscally unsustainable state-run Medicaid program. But is KanCare itself unsustainable? Legislators need to find out and act accordingly.

Somebody needed to get a handle on Medicaid. The health care system that covers the poorest Kansans and aids those with disabilities was claiming a growing share of the state budget – “eating us alive” was how Gov. Sam Brownback put it in 2012. If it sounded too good to be true that private insurance companies could save $1 billion over five years without cutting provider rates, eligibility or services, the notion of “outcomes-focused, person-centered” care was promising.

With KanCare now having been in place for 21 months, though, surely the transitional bumps should be diminishing. No doubt many are.

The administration’s official reports certainly make it sound that way. “A review of claims submitted from January to July of this year shows that 99.98 percent of clean claims are paid within 30 days of submission” to a KanCare company, Kansas Department of Health and Environment spokeswoman Sara Belfry recently said.

But the three companies reported losing a total $110 million last year and another $72.6 million in the first half of 2014. For a time last month, the unpaid KanCare claims at the Hanover Hospital in Washington County were $140,000 – more than half of the hospital’s monthly budget, according to the Kansas Health Institute News Service.

Then there is Randall McVey, a Garden City dentist who didn’t hold back in explaining last week why he is no longer a KanCare provider.

“The system is definitely broken. It’s not working,” he told the Garden City Telegram. “It just seems like the right hand doesn’t know what the left hand is doing.”

McVey told state officials it would be less expensive to give away his services than to continue to spend so much time trying to get paid by the KanCare companies. (He wasn’t kidding: He said he’s now offering to do free dental work for his former KanCare patients if they’ll volunteer their time to help a cause or neighbor.)

Echoing reports The Eagle has heard from other KanCare providers, the Telegram reported that “frequently, vendors would claim they didn’t receive or couldn’t open attachments on claims, or would subsequently find the attachment, promise to reprocess the claim, and the practice would find out months later the claim was again denied.”

It surely didn’t help McVey that KanCare only reimbursed 30 to 50 percent of actual costs of procedures, according to the dentist.

KanCare has become a campaign issue in the governor’s race, which is appropriate but risks politicizing what should be the nonpartisan goal of properly caring for some of the most vulnerable Kansans.

Lawmakers should not consider KanCare a done deal, and should listen not just to the administration but also to providers and patients.

They also should reconsider their opposition to expanding Medicaid under the Affordable Care Act, which would afford KanCare the benefit of many more federal dollars while insuring more Kansans.

For the editorial board, Rhonda Holman