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Aug. 28, 2012
TOPEKA Officials for the three managed care companies hired to run the Kansas Medicaid program announced today the firms that they will be use to provide their transportation, dental, vision and pharmacy benefits.
The subcontractors were mentioned during a two-hour informational meeting put on today in Topeka by the Kansas Department for Aging and Disability Services.
The companies and their benefit management firms:
Sunflower State Health Plan
o Vision – Opticare
o Dental – Dentaquest
o Pharmacy – US Script
o Transportation – MTM
o Vision – Vision Service Plan
o Dental – Scion Dental
o Pharmacy – OptumRX
o Transportation – Logisticare
o Vision – Ocular Benefits
o Dental – Scion Dental
o Pharmacy – Caremark
o Transportation – Access2Care
About 150 people attended the morning session, which was geared toward explaining KanCare to Medicaid service providers. KanCare is Gov. Sam Brownback’s plan for using managed care companies to remake the state’s Medicaid program. Brownback officials say KanCare will save the state and federal governments $1 billion over five years while improving services to Medicaid beneficiaries.
A similar informational meeting for Medicaid clients was held in the afternoon.
Spokespersons for the managed care companies said each of the three was in the process of sending contracts to hundreds of providers across the state, seeking to enlist them in their provider networks.
“If you’ve not received a packet yet, you should by the end of the week,” said Pam Shipley, an executive with Sunflower State Health Plan, a wholly owned subsidiary of Centene. “We are anxious and eager to talk to you.”
To meet their contract obligations with the state, the managed care companies must each have 90 percent of their provider networks in place by Oct. 12 and 100 percent in place by Nov. 16.
KanCare is scheduled to launch Jan. 1, pending the needed federal approvals.
Christine Krause of UnitedHealthcare jokingly described the three companies’ outreach efforts as “No Provider Left Behind,” a reference to the federal education reform initiative “No Child Left Behind.”
According to the company officials, all the plans will offer benefit packages that include incentives for exercise, smoking cessation, wellness checks and preventive dental care. The incentives would vary from package to package and company to company, however.
Andrea Allen, a manager of network development with Amerigroup, said her company’s dental benefit would include teeth whitening and two free cleanings a year. Amerigroup, she said, also will cover counseling for beneficiaries who may be in unhealthy relationships.
Shipley said Sunflower State Health Plan’s package would include respite care for the aged, blind and disabled.
Krause said United Healthcare would cover the costs of some members to join a YMCA or a 4-H Club.
Each of the representatives said their companies were committed to minimizing procedural hassles, paying claims promptly and ensuring a smooth transition to the new program.
During a question-and-answer session that followed the companies' presentations, state officials were asked how they expected the managed care companies to turn a profit.
Russell Nittler, a senior manager with the Kansas Department of Health and Environment, said the KanCare contracts call for the state to pay the managed care companies a set rate that’s “designed to ensure savings” while passing the “risk element” onto the companies.
At the same time, he said, the companies’ profits would be limited. Rates paid to providers would not be reduced.
“We’re not trying to lower the cost of Medicaid or cut Medicaid,” Nittler told KHI News Service. “We’re just trying to bend the curve. That’s where the savings will come from: Bending the curve.”
Lori Feldkamp, executive director at Big Lakes Developmental Center in Manhattan, brought several of her case managers to the session.
“I think we’re still in the general-information stage,” Feldkamp said, referring to the morning discussion. “We were hoping there would be more specific information on how we’ll be transitioning systems, but it doesn’t look like we’re there yet. There’s still a lot of confusion.”
Big Lakes Developmental Center provides home and community-based services for the developmentally disabled in Riley, Geary, Clay and Pottawatomie counties.
“Our main concern right now is timely reimbursement, especially during the start-up,” said Dale Stiffler, a vice president with Easter Seals Capper Foundation in Topeka. “In the other states that have done this, there have been delays in getting paid.”
The KHI News Service is an editorially independent initiative of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Find more about the News Service at khi.org/newsservice or contact us at (785) 783-2529.