A pair of federal officials heard a litany of concerns from KanCare providers and clients Tuesday in Salina as the state prepares to apply for renewal of the managed care Medicaid program.
James G. Scott, associate regional administrator for the Centers for Medicare and Medicaid Services, and Megan Buck, the agency’s program services branch manager, heard about problems with applying for Medicaid, cuts to services and provider reimbursements, and difficulties getting help from the state during the forum at the Bicentennial Center.
Rick Cagan, executive director of the Kansas chapter of the National Association for Mental Illness, told Buck and Scott that the complaints should give federal officials pause as they consider the upcoming application to renew the program past 2018.
“KanCare experiment is still very flawed, and you’re hearing that from many people here today,” Cagan said.
In November 2011, Gov. Sam Brownback announced his plan to reform the state’s Medicaid program. Three private insurance companies were selected to run the $3 billion KanCare program, which launched in 2013 and provides health insurance for more than 425,000 Kansans.
A spokeswoman for state agencies disputed claims that the problems described Tuesday are systemic, telling the Topeka Capital-Journal that the program is working well for most on Medicaid.
But during the forum, providers described a Medicaid system at a breaking point, with cuts to programs meant to keep Kansans out of hospitals and nursing homes coming as those facilities also struggle with reimbursement reductions and long waits for residents’ Medicaid applications to process.
“I have not been approved for a single Medicaid application in my building since October,” said Haely Ordoyne, co-owner of a nursing home in Washington County called Centennial Homestead.
Ordoyne said almost 70 percent of the residents at her 31-bed facility rely on Medicaid.
She and other nursing home administrators, like Charles Smith of Medicalodges in Coffeyville, have watched residents struggle to get applications processed since the state switched to a new computer system last year and funneled all applications through a single KanCare Clearinghouse in Topeka.
Smith said the current wait times are “getting ridiculous” and his small chain of homes is carrying more than $2 million in uncompensated care for Medicaid-pending residents.
Providers of home and community-based support services for Kansans with disabilities said years of stagnant reimbursements have left them unable to recruit and retain enough staff.
Administrators from hospitals large and small said a 4 percent cut in Medicaid reimbursements approved by Gov. Sam Brownback to help balance the budget would make it financially harder for them to provide their full array of services to Medicaid patients.
“Since 1897 when our hospital was founded, we have never reached this type of crossroads,” said Bob Finuf, vice president of Children’s Mercy in Kansas City, adding that Medicaid is a topic of concern at every board meeting. “It’s reached a point where we have to consider options we’ve never had to think about that are extremely anti-cultural to us.”
Scott and Buck listened quietly throughout hours of testimony, asking few questions until the open mic period at the end, when they talked through individual cases with people who stepped up from the crowd of more than 100.
“It’s reached a point where we have to consider options we’ve never had to think about that are extremely anti-cultural to us.”- Bob Finuf, vice president of Children’s Mercy in Kansas City
Scott sought to assure the audience members that their concerns were not falling on deaf ears.
Sean Gatewood, lobbyist for the KanCare Advocates Network, which hosted the event, provided several suggestions for federal officials as they consider the KanCare renewal. They included removing home and community-based services from KanCare, like they were in the program’s first year.
At a minimum, Gatewood said, the state should not be allowed to make further major changes to Medicaid, such as combining waiver services for Kansans with disabilities, while the current problems remain.
“They haven’t proven hypothesis one,” Gatewood said. “We shouldn’t let them go to hypothesis five.”