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Today, Pitch Magazine, a Kansas City alternative newspaper released a scathing, on point analysis of Kansas "KanCare" debacle.

Since learning of his condition in college, Bullers has slowly lost control of his body. But his mind remains clear. These days, the former Kansas City Star reporter spends his days hounding a bureaucracy in Topeka in an attempt to keep in-home nurses all day, every day. This past January, the state transferred the care of 380,000 Medicaid recipients to three private companies as part of a program called KanCare.

Gov. Sam Brownback has said the wholesale privatization of Medicaid under KanCare was meant to save $1 billion over five years. He also promised that the move wouldn't sacrifice Kansans' level of care, and the number of people on Medicaid's waiting list would be reduced.

But the only way for the three managed-care organizations to realize cost savings on clients with permanent physical disabilities, like Bullers, is by cutting Medicaid services. Bullers' 24/7 care was slated to be reduced by November 1 to 40 hours per week. Caregivers, who now work in three eight-hour shifts, could visit him only on weekdays for eight hours a day, or all seven days of the week for five hours each.

"To me, that's an Orwellian clusterfuck," Bullers tells The Pitch. "How can you take out that chunk of money on the backs of the most vulnerable and say with a straight face that you're going to improve services? It defies common sense."

The Pitch of course does all of the leg work in a multi-page piece that deserves to be read.   Because it highlights what is wrong with using a for-profit motive when dispensing need to those who are amongst the most vulnerable.

It isn't as though Kansas couldn't see it coming:

Steve Rose
Star columnist

The Kansas Health Institute has nailed it.

KanCare – to paraphrase – is likely to be a mess when it is implemented on Jan. 1.

On that date 380,000 poor and disabled Kansans, who now receive services through Medicaid, will be shifted to private, managed care in an attempt to save money. The new program is called KanCare.

The KHI researched what has happened in Kentucky, which recently has implemented what we are about to implement. And, so far, it has had lots of hiccups.

And Kentucky did not even include three categories that are included in the Kansas plan: long-term services for the elderly, physically disabled and, eventually, the developmentally disabled.

Pitch lays out the truth in page after page..

Medicaid is a health program for low-income Americans that's funded jointly by states and the federal government. Several states have transferred segments of their Medicaid programs to private insurers to curb rising costs.

While other states have dipped their toes into the privatization of Medicaid, Kansas has cannonballed into the deep end by shifting all of its Medicaid management to three private companies.

"It is the most extensive in the nation," says Gary Blumenthal, a former Kansas legislator who is now CEO of the Association of Developmental Disabilities Providers in suburban Boston and a member of the federal National Council on Disability. "Other states have viewed managed care as an area to move slowly and cautiously in the use of managed care, to determine if the use of managed care can produce the savings that advocates claim can occur while preserving the quality and safety for people that it would be serving."

Brownback has made every effort to twist the truth and portray this story one way.. when it is far different than that.
"The process has not gone as smoothly as the people at the Statehouse would have you believe, as far as the implementation is concerned," said Allen Van Driel, CEO of Smith County Memorial Hospital in north-central Kansas, according to a September 23 Kansas Health Institute News Service report. "The party line is that the managed-care plans are working and that KanCare is a huge success, that it's processing claims and all that. But that's simply not factual."
This is a powerful piece that needs to be read by more people.   What it doesn't touch on, though is the falseness of this dilemma altogether.  Those like Brownback assert that there simply isn't enough money to support all those who are sick and disabled, therefore they must cut costs.  What isn't be said is that there is another alternative to continuous cutting of costs.. it's called increasing revenues.   Brownback and others hate that - cut, cut cut is the only way.   But in the end, part of the social responsibility has to be the fact that we care for those who need it most.   This means that we count on companies not getting over the top tax breaks, we ask that people carry their weight and we provide for our population.

But that kind of talk makes people unhappy.   Too bad, because tonight here in KC there are a lot of people on a wait list that is now 7+ years long who won't get services because the continuous cuts to healthcare in Kansas.

Thu Nov 21, 2013 at 2:40 PM PT: This is an OLD update, but I thought relevant here, after someone sent it

Gov. Sam Brownback’s Medicaid makeover has been putting a financial squeeze on small Kansas pharmacists and spokespersons for the hometown druggists are calling for the administration to enforce the terms of its contracts with the three KanCare managed care companies.

“I think the simple answer is for the State of Kansas to make sure the MCOs (KanCare managed care companies) are living by their signed contracts and that should have been ready to go Jan. 1 (when KanCare was launched),” said Mike Larkin, executive director of the Kansas Pharmacists Association.

“We understand there will be bumps and hiccups in the implementation of a new program, but I can't help but think that if the shoe was on the other foot and they (the MCOs) were losing money instead of making money, they would have been on this (problem) a lot quicker,” he said.

Pharmacists say the heart of the issue is that the KanCare companies — Amerigroup, UnitedHealthcare and Sunflower State Health Plan — often fail to reimburse the druggists for the costs they incur serving Medicaid enrollees.

“I guess the bottom line is that we were led to believe in the first year (of KanCare) that there would be no changes on reimbursement or anything,” said Ron Booth, owner of the Corner Pharmacy in Leavenworth. “But you see, these (KanCare MCOs) are for-profit companies. They are changing all the rules and no one in Topeka is holding them accountable. I'm speaking out of frustration as a small, locally owned pharmacy. I want to be treated fairly.”

Originally posted to tmservo433 on Wed Nov 20, 2013 at 04:33 PM PST.

Also republished by Kansas & Missouri Kossacks.

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