Medicare is a federal health insurance program for people over 65, regardless of income level.
Medicaid is a federal health insurance program run by the states for people with low-incomes.
KanCare is the Governor’s plan to move nearly all of Kansas’ Medicaid enrollees (approximately 380,000) into managed care plans run by three for-profit managed care organizations (MCOs.) On June 27, 2012, Sunflower State Health Plan (a subsidiary of Centene), United HealthCare and Amerigroup were announced as the three winners of KanCare contracts. Without cutting rates, KanCare was created to cut Medicaid spending in Kansas by $1 billion over the next five years through improved coordination of care, early intervention and reduced inpatient and residential care.
Kansas already has one of the most restrictive Medicaid programs in the nation, serving only the elderly, disabled, pregnant and young poor. Only seven other states in the nation have a smaller percentage of Medicaid enrollees than Kansas.
That said, Medicaid is the second costliest obligation of the state after education. The cost of the Medicaid program in Kansas has increased from $1.25 billion in 2000 to an estimated $3.2 billion in FY2013. The state of Kansas’ total budget for FY 2013 is about $14.3 billion. It would be difficult to argue that there is no need to reform Medicaid. The question is, what way is the best?
Under KanCare, Medicaid members will be divided up between the three MCOs. Each MCO will authorize the members’ medical care and other home and community based services as necessary. They will also provide “value-added” services designed to help improved the quality of health care, access to services and health literacy of its members. Members have 45 days after the start of KanCare to switch MCOs if they feel another one is better for them.
Because there are many unknowns about how the three MCOs will approach helping the state trim its Medicaid spending by $1 billion over five years, there is understandable concern within the patient and provider community. And, although the federal government has not yet approved KanCare, all indications are that KanCare will be implemented January 1, 2013 as planned.
For more information about KanCare, you may go to the KanCare website at www.Kancare.ks.gov or to the Kansas Health Institute, an independent, nonprofit health policy and research organization based in Topeka, at www.KHI.org.
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