KanCare plays a vital role serving those facing economic and social barriers to getting healthcare and improving the health and wellbeing of these Kansans. KanCare helps over 497,000 Kansans get the healthcare they otherwise would not be able to afford.1
Serving Kansas since 2013
Since the inception of KanCare, private MCOs have been held to high standards by the state, including up to 69 quality measures annually.2
Kansas requires all MCOs to obtain National Committee for Quality Assurance (NCQA) accreditation5
Helping 497,000 Kansans
In 2022, 1 in 12 adults, 4 in 7 nursing home residents, and 2 in 7 individuals with disabilities were covered by KanCare. Private MCOs in Kansas oversee network management, claims payment, care coordination, and utilization management for thousands of Kansans.6
With the costs of healthcare rising, states need a way to plan and manage their budgets while ensuring that Medicaid recipients get the high-quality healthcare they deserve.
Through KanCare, private MCOs in Kansas have helped increase the use of several preventive services, including primary care, behavioral health, and dental services. Since KanCare began, use of behavioral health services—such as counseling and addiction services—has increased 8%.7
In 2019, private MCOs provided
in additional services to prevent members from needing higher cost services later.11
With managed care, states pay a fixed, per-member, per-month rate, which allows them to budget with transparency and predictability. Between 2013 and 2018, the managed care model helped KanCare avoid $2 billion in healthcare costs.8
Improved population health
Private MCOs have also helped increase the use of other key services. Between 2021 and 2022, prenatal care increased 9% and annual childhood dental visits increased 9%.13
In 2019, private MCOs provided more than $3.3 million in value-added services, such as smoking cessation and weight management programs, that helped Kansans be healthier.11
Kansas MCOs were also ranked in the top 10% nationally for mental health follow-up in 2022.13
Coordinated care for Kansans
Private MCOs coordinate care and provide a single point of contact for Kansans, creating a better experience.
Private MCOs in Kansas conduct outreach to thousands of current and potential KanCare members to help them make informed decisions about their KanCare plan and benefits. Kansas’ private MCOs also coordinated immunization clinics and worked with community-based organizations across the state to address issues related to employment, housing, and food disparities.1
of adult recipients rated KanCare MCOs an 8 out of 10 or higher in 2021.13
Nearly 90% of adult recipients rated their coordination of care at an 8 out of 10 or higher in 2020.12
Nearly 82% of parents rated their child’s health plan at an 8 out of 10 or higher in 2020.12
The rating of KanCare’s health plan for children and children with chronic conditions were highly ranked (>75th) among MCOs.12
Helping Kansas help providers
Private MCOs use value-based payment models that incentivize, empower, and reward providers for the quality of care. During COVID-19, private MCOs are providing advanced payments to providers (separate from the CMS payment program) and advocating for additional federal action that can ensure critical support to providers during this pandemic.10
Private MCOs in Kansas also submit quarterly provider network adequacy reports. In 2020, the state of Kansas met with the state’s private MCOs to collaborate on and improve provider network reporting processes.1 The focus is on keeping individuals healthy and delivering better outcomes. Over time, this improves overall population health and reduces the total cost of care.
- “Kansas Medical Assistance Report Fiscal Year 2023,” kancare.ks.gov. 2023
- “NCQA Health Insurance Plan Rating 2019-2020 – Summary Report (Private/Commercial),” NCQA, 2020.
- “History of KanCare,” NCQA, 2018.
- “Report of the Robert G. (Bob) Bethell Joint Committee on Home and Community Based Services and KanCare Oversight to the 2019 Kansas Legislature,” Kansas Legislative Research Department, 2019.
- “Quality Management,” KanCare, 2020.
- “Medicaid in Kansas,” KFF, 2022.
- “Medicaid: Evaluating KanCare’s Effect on the State’s Medicaid Program,” Legislative Division of Post Audit State of Kansas, 2018.
- “KanCare Info Sheet,” KanCare, 2018.
- “Annual EQR Technical Report,” KanCare, 2020.
- “MHPA Applauds the House of Representatives for Prioritizing Medicaid in ‘Phase 4’ COVID-19 Legislation,” MHPA, 2020.
- “KanCare Executive Summary,” kslegislature.org, 2020.
- “KanCare Dashboard,” kancard.ks.org. 2021
- “2021-2022 Annual EQR Technical Report,” kancare.ks.gov. 2022.