Spoiler alert in one word: Privatization. Here is a brief description of the privatized Kansas Medicaid program, “KanCare,” from the Kansas state legislature’s Legislative Division of Post Audit (DPA). Page 7 of the PDF:
Launched in January 2013, KanCare is the program through which the State of Kansas administers Medicaid. KanCare offers health care for people with limited income, which may include pregnant women, children, and low-income families with children. The Kansas Department of Health and Environment (KDHE) and the Kansas Department for Aging and Disability Services (KDADS) jointly administer KanCare. KDHE maintains financial management and contract oversight of the KanCare program. KDADS administers the Medicaid waiver programs for people with disabilities, mental health conditions, and substance abuse problems, and oversees the state hospitals and institutions.
As the state’s Medicaid program, KanCare focuses on providing person-centered care coordinated through contracts with three private managed care organizations [MCOs]: Amerigroup of Kansas Inc., Sunflower Health Plan, and United Healthcare Community Plan of Kansas. The state also contracts with Maximus [hmm…], a company that processes the state’s Medicaid applications and provides support services during the eligibility process.
Or in short form:
[KanCare is depends on] a federal waiver that allows the state to contract with three private companies to operate KanCare, a $3 billion program that covers more than 420,000 low-income, elderly and disabled Kansans.
And let’s not forget Maximus, the fourth company!
I’m sure the KanCare story is a lot more complicated and horrid than this superficial survey will reveal — Kansas readers please chime in! — but even so things look pretty bad. (Note that KanCare is for existing Medicaid, not Medicaid expansion.) I’m going to start with the story on KanCare’s data debacle, move through their eligibility determination debacle, and close, for a change, with a bit of good news.
– Naked Capitalism