Managed care execs meet with KanCare advisory group

Each pledges to minimize procedural hassles when new system is launched

By Dave Ranney, KHI News Service, July 10, 2012

KanCare MCO representatives respond to questions from the KanCare Advisory Council

Left to right are KanCare managed care executives: Holly
Benson of Centene, Laura Hopkins of Amerigroup, and Nan
Thayer Kartsonis of UnitedHealthcare. (Photo by Dave Ranney)

TOPEKA — Representatives of the three managed care companies picked to run Kansas' $2.8 billion Medicaid program said Monday that they would keep the new system’s procedural hassles to a minimum.

“It’s not like each of us are going to come in with new forms and administrative procedures,” said Holly Benson, senior vice president of health policy for Centene, speaking at a meeting of the KanCare Advisory Council.

KanCare is Gov. Sam Brownback’s plan to overhaul the state’s Medicaid programs in ways administration officials say will improve quality and lower costs.

Appearing with Benson were Laura Hopkins, chief plan executive officer for Amerigroup Kansas, and Nan Thayer Kartsonis, president of UnitedHealthcare of the Midwest.

All three said their companies’ procedures for credentialing, billing and measuring outcomes would be similar to those already in place.

“We depend on our providers,” Benson said, referring to physicians, hospitals, safety net clinics, pharmacists and other Medicaid health care providers. “If they’re not happy, we’re not doing our jobs.”

The KanCare program is scheduled to launch Jan. 1, pending the needed federal approvals.

Benson, Kartsonis and Hopkins each said their companies would have administrative offices in Kansas and would operate websites and toll-free call centers to assist providers and beneficiaries.

Each company plans to hire between 200 and 300 workers in Kansas, the executives said.

The companies plan to offer incentive packages aimed at rewarding beneficiaries for leading healthy lifestyles – losing weight and smoking cessation, mostly. They also plan incentives for those who keep their medical appointments and follow doctor-prescribed regimens for addressing chronic conditions such as asthma and diabetes.

“We’ll have debit cards with points that they can use to purchase baby items, child care or over-the-counter medications,” said Amerigroup’s Hopkins, describing the incentives her company plans to use.

Kartsonis said UnitedHealthcare would pay membership fees for youth sports programs, Boys and Girls Clubs, and YMCAs in order to encourage exercise and fitness.

The company, she said, also would cover the costs of beneficiaries taking part in the Weight Watchers program. Those who remain in the program for three months would receive a “$50 prepaid Master Card” with the understanding that it would be used to buy “workout clothing.”

UnitedHealthcare also plans to offer grants to schools for obesity-prevention programs.

“We’ll also buy cell phones for our high-risk members who live in remote areas so that we’ll be able to communicate with them,” Kartsonis said.

Kartsonis also said UnitedHealthcare was exploring the possibility of investing $500,000 in one or more jobs programs for the developmentally disabled.

All three executives said their companies would provide adult Medicaid beneficiaries with free preventive dental care - exams, X-rays and cleanings - but would not cover regular dental care.

Neither preventive or regular dental services currently are provided through the program to adults. Children on Kansas Medicaid or CHIP (Children’s Health Insurance Program) already are eligible for regular dental care – fillings and extractions, generally. They would continue to receive those services under KanCare.

The executives also said their companies would not steer beneficiaries to mail-order pharmacies but would instead rely on brick-and-mortar Kansas pharmacies.

“That’s good news,” said Mike Conlin, a council member and owner of Jayhawk Pharmacy and Patient Supply. “But I have to say that none of my colleagues have been contacted by any of the three companies, or at least that’s what they’ve told me. I know they haven’t contacted me. Maybe they just haven’t gotten around to us, I don’t know."

Jayhawk is an independent pharmacy and durable medical company in Topeka.

Though the two-hour briefing was cordial, some on the advisory council were skeptical of KanCare's prospects.

“I just hope the governor – his administration – does a better job with this than he’s done with the DMV,” said Rep. Jerry Henry, a Cummings Democrat and a member of the council.

He was referring to recent computer malfunctions at the Kansas Department of Revenue that resulted in lengthy delays in the Division of Motor Vehicles’ ability to process driver's license renewals and car tag payments.

“I was generally happy with what I heard from the three MCOs (managed care companies) and with what they had to say about the value-added benefits,” said Dr. Kevin Bryant, medical director for several Wichita-area nursing facilities. “But the proof in all this is going to be how good of a job they do in care coordination at the member level and actually helping and encouraging people to improve their health. That’s where the savings are going to come from.”

The advisory council’s next meeting is scheduled for 2 p.m. Sept. 13 in the fifth-floor conference room on the Curtis State Office Building, 1000 SW Jackson, Topeka.

The KHI News Service is an editorially independent program of the Kansas Health Institute and is committed to timely, objective and in-depth coverage of health issues and the policy making environment. Read more about the News Service.

http://www.khi.org/news/2012/jul/10/mco-execs-meet-kancare-advisory-group/

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