Governor Sam Brownback on Tuesday proposed sweeping changes to the state’s medical programs for low-income, elderly, and disabled Kansans. In a news release, the governor said the plan was based on three criteria: improving the quality of care of Kansans receiving Medicaid; controlling costs of the program; and long-lasting reforms that improve the quality of health and wellness of Kansans.
The cornerstone of these initiatives is an integrated care system, called KanCare, focused on improving health outcomes for Kansans that will bend the cost curve of Medicaid down over time. The release indicates the programs will aim toward outsourcing the coordination of health care, creating employment opportunities for the disabled, and realligning state agencies.
KanCare will lead and implement some coordination processes that are not currently in place. The state will submit a request for proposal (RFP) to coordinate all aspects of behavioral and physical health, as well as services for the aged and disabled. KanCare will align incentives for the payer, providers, and consumers to promote the best outcomes for Kansan
The state expects the program to net significant saving through improved care coordination and achieving improved outcomes. Over five years, the state expects to reduce growth in Kansas Medicaid spending by 8-10 percent, which equates to 1/3 reduction in total Medicaid growth. Based on a conservative baseline of 6.6% growth in Medicaid without reforms (the actual historic growth rate over the past decade was 7.4%), the outcomes-focused, person-centered care coordination model executed under the RFP is expected to achieve savings of $853 million (all funds) over the next five years. These savings occur without cutting provider rates, throwing people off the system, or reducing essential benefits.
“Our goal is improving care and the experience for Kansans. The new system will achieve cost savings through improving outcomes for needy Kansans,” Lt. Governor Colyer said. “Serving the needs of the whole person and as well as ensuring long term fiscal sustainability are the principles this plan is built upon.”
The State of Kansas will create new and strengthen existing programs designed to facilitate work opportunities for people with disabilities to transition from Medicaid to work and independence. SRS, working with the Department of Commerce are working to implement an innovative program to align current Medicaid recipients who want to work with resources available at Workforce Centers located throughout the state. The state also will work to leverage state employment opportunities and opportunities to leverage state purchasing power to employ people with disabilities.
To continue public engagement for Medicaid reform the Administration will create an advisory group to provide counsel on policy decisions, throughout the implementation process and continuing once implementation occurs. The group will consist of Kansas seniors, persons with disabilities, advocates, providers and other interested Kansans.
In addition to reforms to Medicaid programs, a realignment of state agencies will increase administrative coordination and streamline Kansans’ interactions with state government. The realignment will lead to better communication and reflect the Kansas’ commitment to coordination across services and programs.
The realignment will consolidate Medicaid fiscal and contract management in the Kansas Department of Health and Environment (KDHE) and program management in a reconfigured Kansas Department on Aging (KDOA). KDOA will combine with the Division of Disabilities and Behavioral Health Services from Social and Rehabilitation Services (SRS), which includes Home and Community Based Services (HCBS) waivers. KDOA will also administer the mental health programs and the five state hospitals. KDOA will become the Department for Aging and Human Services.
The reconfiguration will allow SRS to further strengthen its targeted focus on children and family services. SRS will continue to administer Adult Protective Services. The agency will also take over nine family preservation and social programs currently administered by KDHE, as well as some prevention programs from the Juvenile Justice Authority. SRS will now be called the Department for Children and Family Services.