MON D AY, FEBR UAR Y 20, 2012
Department on Aging Secretary discusses Medicaid reform
ansas Department on Aging Secretary Shawn Sullivan stopped by the Journal-World on Feb. 6 to discuss the state’s plan to privatize the Medicaid program, and other policies regarding senior care, through a live chat on WellCommons.com. Sullivan heads the Department on Aging which is responsible for administration of Older Americans Act programs, distribution of Medicaid long-term care payments, and regulation and survey processes for several different adult care home licensure categories. Sullivan has been involved with aging services for 18 years. Before heading the Department on Aging, he was executive director of Kansas Masonic Home in Wichita, Sullivan which received a state award for its efforts in culture change and person-centered care. The following is an excerpt from the chat. The full text can be found at http:// ljw.bz/xFDLac. Moderator: Thank you for taking time out of your busy schedule to participate in this online chat. I am health reporter Karrey Britt and will be moderating this chat. First, can you briefly explain KanCare? In a poll, a majority of people say they don’t understand it. Shawn Sullivan: Happy to be here. Thank you for hosting. Currently, Kansas serves 383,000 seniors, persons with disabilities and low-income family and kids through the state’s Medicaid program. About two-thirds of those 383,000 are in a managed care program. The remaining populations, mainly seniors and persons with disabilities, will be moving to a managed care plan through KanCare vendors effective January 2013. The KanCare system is intended to serve Kansans through a concept called a patient-centered medical health home. The health home will allow for enhanced care coordination, particularly for those with chronic conditions and/or mental health conditions. All Medicaid consumers will be rolled into one of three KanCare companies. The state will pay these three vendors a set amount per month to manage all of that person’s care through the organizations in their “provider network.” KanCare is intended to achieve better outcomes through this health home model and decrease utilization of high cost services (emergency room, nursing facilities, etc.),
increase reliance on home and community based settings, and better integrate the mental health and medical care a person receives. I could go on and on — but that is a basic summary. gayle: This is a practical question. Once KanCare is implemented, will patients contact their physicians directly to make appointments or go through their medical home? Many clients also need transportation arranged for appointments. Will this be done directly or, again, through their medical home? Sullivan: It depends on the situation. In general, the medical home is intended to help a consumer and their family navigate the system and make sure the various needs of the consumer are met and coordinated. They will need to know about an appointment if they are to help the various systems (physicians, speciality physicians, mental health counselors, etc.) communicate and coordinate care. neuhofel: Do you feel physician (or mid-level provider) in-home visits are a valuable and cost-effective mechanism to help keep older adults in their homes? and if so, what existing state-level policies (or proposals) will help encourage providers to offer such services? Thanks, Dr. Neu Sullivan: We do feel that physician extenders are a valuable resource. Research has shown that the use of ANRPs, for example, in an enhanced care coordination role can be a very effective way to better health outcomes, increase care coordination and reduce costs to high cost services. We did ask in our KanCare request for proposal how the bidders would effectively utilize physician extenders within the new system. The patient-centered medical health home, in other states, has utilized physician extenders for some populations to increase the care coordination. The proposals for these health homes will be one of the aspects the bids, that came in on Jan. 31, will be evaluated on.
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Sullivan: Thank you all for joining us. The KanCare system is truly intended to achieve better outcomes for those it will serve. … I encourage you all to find out as much as you can about the new system. You can find out more by visiting agingkansas.org, at the “KanCare Information” link. You can also ask more questions by emailing KanCare@ ks.gov. You can also find out more on the patient-centered medical health home approach on the RFP link on the website.
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