Healthcare for Kansans when they need it

A Look At The Numbers provides information on how private managed care organizations (MCOs) partner with Kansas to administer Medicaid benefits. Medicaid managed care enables Kansas to deliver higher quality care, improve health outcomes of Medicaid recipients, and manage healthcare costs. The care people need, when they need it. That is the model of managed care.

KanCare: Kansas' Medicaid program

KanCare plays a vital role serving those facing economic and social barriers to getting healthcare and improving the health and well-being of these Kansans. KanCare helps over 408,000 Kansans get the healthcare they otherwise would not be able to afford.¹

Program history

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

2013
KanCare begins³
2013
Bob Bethell KanCare Oversight Committee established⁴
2013
Kansas requires all MCOs to obtain National Committee for Quality Assurance (NCQA) accreditation⁵

Program population

Helping 408,000 Kansans

In 2019, 1 in 14 adults, 1 in 2 nursing home residents, and 1 in 4 individuals with disabilities were covered by KanCare.⁶Private MCOs in Kansas oversee network management, claims payment, care coordination, and utilization management for thousands of Kansans.

2 in 7

children covered by KanCare⁶

Controlling costs

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

$14.1M

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

Increased use of primary care services

45%⁷

Private MCOs have also helped increase the use of other key services. Between 2013 and 2019, prenatal care increased 7% and annual childhood dental visits increased 9%.¹¹

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 2019.⁹

Patient experience

Coordinated care for Kansans

Private MCOs coordinate care and provide a single point of contact for Kansans, creating a better experience.

In 2019, private MCOs in Kansas conducted 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

78%

of adult recipients rated KanCare MCOs an 8 out of 10 or higher in 2019.⁹

Provider experience

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.

Downloads

Citations

¹ https://kancare.ks.gov/docs/default-source/policies-and-reports/annual-and-quarterly-reports/annual/kancare-4th-quarter-and-annual-report-to-cms-year-end-12-31-2019.pdf?sfvrsn=b9634e1b_10
²https://healthinsuranceratings.ncqa.org/2019/Default.aspx
³ https://www.kancare.ks.gov/about-kancare/history-of-kancare
⁴ http://www.kslegresearch.org/KLRD-web/Publications/CommitteeReports/2018CommitteeReports/hcbs-cr.pdf
⁵ https://www.kancare.ks.gov/policies-and-reports/quality-measurement
⁶ http://files.kff.org/attachment/fact-sheet-medicaid-state-KS
⁷https://www.kslpa.org/wp-content/uploads/2019/07/r-18-006.pdf
⁸https://www.kancare.ks.gov/docs/default-source/home/2018-kancare-infosheet.pdf
⁹https://kancare.ks.gov/docs/default-source/policies-and-reports/eqro-reports/_20200529-annual-eqr-technical-report.pdf?sfvrsn=bc54e1b_6
¹⁰ https://medicaidplans.org/wp-content/uploads/2020/05/2020PR_MHPAStatement_HouseBill_May-15.pdf
¹¹http://kslegislature.org/li_2020/b2019_20/committees/ctte_jt_robert_g_bob_bethell_joint_committee_1/documents/testimony/20200228_92.pdf

A Look At The Numbers is an educational resource about Medicaid managed care, hosted and supported by Medicaid Health Plans of America, in collaboration with other Medicaid managed care organizations and state health plan associations.