TOPEKA — The state's top health official today fielded questions about the administration's Medicaid makeover plan from some openly skeptical members of the Senate Public Health and Welfare Committee.
After it became obvious the committee had more questions than time, Dr. Robert Moser, secretary of the Kansas Department of Health and Environment, was asked to return for a second round on Thursday.
KDHE Secretary Robert Moser
The committee, chaired by Sen. Vicki Schmidt, a Topeka Republican, already had scheduled two days to review the administration's plan, which would expand managed care to include virtually all of the state's Medicaid program and call for reorganizing three major agencies in the process.
The plan was first announced in November, and Moser and other administration officials faced less intense questioning in recent appearances before interim committees.
Moser's department includes the Division of Health Care Finance, which currently oversees finances and claims for the $2.6 billion Medicaid program.
"I'm too old to agree with you," said Sen. Roger Reitz, a Manhattan primary care physician, after hearing Moser describe how the administration's plan would improve Medicaid patient outcomes, safeguard provider payments but ultimately cut costs by $853 million over five years, according to projections that administration officials have described as conservative.
"I have to tell you I'm very skeptical," Reitz said, noting that Medicaid patients are among the most difficult people to treat. "Medicine doesn't work that way. I haven't seen it done in 50 years of practice."
Moser had told the committee that the plan's success would be tied to better care coordination and accountability for patient outcomes on the part of providers and the managed care companies from which the administration is in the process of soliciting bids. The plan also will emphasize "patient-centered" care and health literacy.
Administration officials have said they want three managed care companies, each operating statewide, on the job by Jan. 1, 2013.
Two managed care companies currently provide HealthWave services to about 238,000 Kansas children and pregnant women in low-income homes. The administration wants to extend managed care to Medicaid beneficiaries who are elderly, disabled and/or mentally ill.
As states seek to curb Medicaid spending, more have turned to managed care companies with mixed results.
Moser was asked by at least two committee members to name states where expanded managed care has worked or served as models for the administration as it crafted its plan.
He responded by saying officials had reviewed Medicaid managed care in most of the states that have it, but specifically mentioned Arizona, Wisconsin, Texas, New Mexico, North Carolina and Florida.
He said the administration was moving more slowly than Kentucky did when it expanded managed care.
"Kentucky took eight months," he said, noting that the administration had been gathering "stakeholder" input for almost a year.
"This has been a very deliberate and measured process to try to make it right for Kansas," he said.
Before taking questions, Moser also told the committee that the administration had discussions with some local public health departments to see if they could be more involved with coordinating the care of Medicaid patients.
Sen. Dick Kelsey, a Goddard Republican, asked who had been responsible for writing the thick request for proposals that the various managed care companies have been poring over in anticipation of the Feb. 22 deadline for submitting bids.
"Who is the ultimate go-to person?" Kelsey asked. "We can't find that."
Moser said the document was the work of multiple authors but ultimately was the product of a sub-Cabinet group that included himself, the secretaries of the Kansas Department on Aging and the Kansas Department of Social and Rehabilitation Services, and other key agency officials.
When senators ran out of time before finishing their questions, Schmidt asked Moser if he could return Thursday, to which he agreed.
The committee normally meets at 1:30 p.m. in Statehouse Room 546-S. Schmidt said it would meet at 1 p.m. Thursday to allow more time for questions.
http://www.khi.org/news/2012/jan/11/kdhe-chief-describes-medicaid-plan-senate-committe/
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