Medicaid Cuts

Last Wednesday, Governor Sam Brownback’s office announced his signing of the budget bill which ordered $97 million in cuts to state spending. Those cuts include $38 million to provider reimbursement rates, which means that health care providers such as dentists, physicians, pharmacies, and urban hospitals who serve Medicaid (KanCare) patients will see their reimbursement rates drop by 4% starting July 1, 2016.

No input or comments were sought from the state’s healthcare organizations by the administration in consideration of the budget cuts, so on Tuesday, May 24, Niki Sadler from the Kansas Dental Association joined representatives from ten other state societies, along with KDA lobbyists John Peterson and Bill Brady of Capital Strategies, to explore what actions the organizations could collectively take to let the administration know that the budget bill is bad public policy and threatens access to care in Kansas.

“Since the announcement from the Governor’s office last week, we have heard from concerned KDA members about how the Medicaid rate reduction will hurt their business when the already low dental reimbursement rates and delayed payments have them providing the care at a loss.” said Niki Sadler.

The other healthcare organizations that took part in this meeting were the Kansas Hospital Association, Kansas Medical Society, Kansas Optometric Association, Kansas Pharmacists Association, Leading Age Kansas, Association of Community Mental Health Centers of Kansas, Kansas Health Care Association, Kansas Association for the Medically Underserved, Kansas Association of Osteopathic Medicine, and the Kansas Academy of Family Physicians.

Although the administration reported that it does not believe the lower reimbursement rates will result in Medicaid patients losing access to health care providers, many of the healthcare organizations that gathered today were not so optimistic. To further complicate matters, if the Kansas Supreme Court rules against the state in the pending school finance case, more cuts could affect Medicaid which could amount to an additional $30-40 million.

KanCare Forums

Coincidentally, yesterday afternoon was the first of ten KanCare forums to be hosted by State officials regarding their preparations to renew the KanCare Medicaid program. The current KanCare program is approved through December 31, 2017. Kansas will submit an application to renew the KanCare program in November of this year and the forums are intended provide an opportunity for stakeholders to learn about the potential changes being considered and to provide feedback as the renewal process progresses.

Niki Sadler, Operations Coordinator for the Kansas Dental Association, attended the public forum held today at the Ramada Hotel and Convention Center in Topeka. Dr. Susan Mosier, Secretary of the Kansas Department of Health and Environment (KDHE) provided information about potential changes being considered for the KanCare contract renewal.

Three significant changes were introduced for public discussion. They were:

• Better coordination and integration of care
• Value based purchasing (outcomes-driven payment)
• Provider network structure and protections

Questions pertaining to each area of focus were presented for group discussion at each table and comments and concerns were to be written down for collection by Wichita State University Community Engagement Institute who will organize and prepare the data for the State. Each group had the opportunity to voice one of their group’s comments to the entire audience. Due to the vagueness of the discussion topics and having very little information regarding what the changes would look like, the discussion yielded a wide variety of feedback and observation.

Access to care and the reduced Medicaid reimbursement rates were hot topics at the forefront of several conversations. These two issues are directly related to maintaining the provider network which is a vital piece to accessible healthcare in the state. “At this point, it is important for providers to voice their concerns related to the KanCare renewal as the State moves forward with determining the changes to the KanCare renewal application.” said Niki Sadler.

Other potential changes or improvements that were not discussed during today’s forum were:

• Use of block grant structure for Kansas Medicaid services
• Effective waiver integration
• Strengthening supports for members to obtain and maintain competitive, integrated employment
• Other stakeholder suggestions
  
  

Stakeholder Feedback Forums
1:00-3:00 PM and 5:30-7:30 PM in each location below

Wednesday, May 25, 2016
Marriott Wichita – Wichita, KS
Jack Reardon Civic Center – Kansas City, KS

Thursday, May 26, 2016      
Rose Garden – Hays, KS
Pittsburg State University – Pittsburg, KS

Feedback from the stakeholder forums will be reviewed by the State and used to guide the draft application development. If you cannot make it to one of the above forums, submit your comments to KanCareRenewal@kdheks.gov.

A draft version of the renewal application will be available on the KanCare website at www.kancare.ks.gov and then public hearings and tribal consultations will be conducted and feedback will be solicited through August 2016.