Last week, Kansas hospitals met with the state and the Medicaid managed care organizations to learn more about how the state and the MCOs intend to implement the program cuts announced by Gov. Brownback to help the state balance its budget. The Kansas Department of Health and Environment and KanCare's managed care organizations – Amerigroup, Sunflower Health Plan, and UnitedHealthcare – provided an overview of the cuts and timelines for implementation. This webinar was recorded, and is available for replay.
This was the first time Kansas hospitals have seen any specificity from the state about the way the cuts will impact providers. And what we heard confirmed something we have been arguing to the Governor, lawmakers and the Centers for Medicare & Medicaid Services: information surrounding the announcement of the cuts was misleading. For those affected hospitals, the amount of the cuts is more than the announced 4 percent--it is at least 6 percent and could be as high as 10 percent because of the "add-ons" included in Gov. Brownback's package.
We also were struck by the state's admission of another troubling point—KDHE has not yet made payments to hospitals this year under the provider assessment program because CMS has not specifically approved some changes in the formula; however, KDHE intends to implement the Medicaid cuts without CMS' approval.
It has become abundantly clear that little or no thought was put into the substance of how Gov. Brownback's Medicaid cuts would be implemented. It appears that KDHE staff and the three MCOs were handed a casserole of wrongheaded policy, unrealistic timelines and bad data, and then were told to figure out how to get Kansas health care providers to eat it.
The result? A Medicaid program that was already struggling due to a plethora of implementation issues has now had another huge burden placed squarely on its back. And ultimately, of course, it will be the people this program is supposed to protect, along with the providers serving them, who suffer the most.