WellCommons

TOPEKA — Experts on states converting to privately managed Medicaid systems on Monday warned of problems Kansas may face as it follows this path.

"This is high stakes stuff," said Joan Alker, co-executive director of the Center for Children and Families at the Georgetown University Health Policy Institute.

Alker said that as Kansas transfers management of its Medicaid recipients to for-profit insurance companies there is the risk of a reduction in needed care.

"You have to be really careful about it," she said, especially when dealing with those with disabilities. "In some cases it may be a life or death question," she said.

Alker and Jodi Mitchell, executive director of Kentucky Voices for Health, spoke at a summit on Medicaid and managed care that was put together by the Kansas Health Consumer Coalition. Gov. Sam Brownback is pushing the Kansas Medicaid program into a managed care system called KanCare that will take effect January 2013.

Medicaid is the state and federally funded health care system that in Kansas serves more than 350,000 low-income children, pregnant women, the elderly and those with disabilities.

Brownback has maintained that the change will reduce state expenses in the program and improve health care by establishing monetary rewards and penalties for the companies managing Medicaid recipients.

But Alker said that based on states that have already switched to managed care there is no evidence this will happen. "The jury is still out. It is just not clear if managed care is saving money," she said. And Alker said that contrary to statements from supporters of managed care, Medicaid spending in Kansas is not a crisis.

As a percentage of state funding, Kansas is spending less than the national average and less than the regional average. Nationally, states are spending 11.3 percent of their state dollars, while in Kansas that is 9.1 percent, she said. Regionally, Medicaid is 15.4 percent of total health care spending, while in Kansas it is 12.1 percent.

"A lot of misinformation tends to happen," when it comes to Medicaid spending, said Alker.

Mitchell has been working on behalf of consumers in the transition to a managed care system in Kentucky.

The system, which was recently launched, has been beset with confusion on the part of patients and providers saying they weren't getting paid in a timely manner, Mitchell said. A state audit released last week said that the governor's cabinet in Kentucky was ill-prepared to monitor and enforce its contracts with the new managed care companies.

As the Kansas University Cancer Center prepared for a site review visit from a National Cancer Institute team, the Hall Family Foundation announced Monday a $10.5 million donation to support KU’s effort to earn NCI designation.

“The Hall Family Foundation has been pleased to partner in striving for National Cancer Institute designation. We remain committed to that goal and to the benefits it would bring to patients in this region and to research efforts to eliminate cancer,” said Bill Hall, president of the Hall Family Foundation. “We applaud all those involved in this life-saving work.”

KU officials expressed gratitude for the foundation’s gift. “The Hall Family Foundation has been an extraordinary collaborator in building a world-class cancer center for our region,” said Dr. Barbara Atkinson, Executive Vice Chancellor of the KU Medical Center. “Attaining National Cancer Institute designation requires significant resources to recruit world-class scientists and build state-of-the-art laboratories. The Hall Family Foundation has made strategic investments all along the way, and in doing so, is helping to transform our region into a national hub of life-sciences research.”

Dr. Roy Jensen, director of the KU Cancer Center, stated: “We are at the forefront of discovering new treatments, and our success is due in large part to generous support from the Hall Family Foundation, which has helped recruit the brightest minds in cancer research. “All of us share one goal … to eliminate the burden of cancer. Such an enormous challenge demands cooperation among many institutions, a spirit of activism and a truly vibrant connection to the people in our communities. The Hall Family Foundation exemplifies that spirit.”

Of the $10.5 million gift, the KU Cancer Center will receive $7 million to fund new faculty and researchers at the KU Clinical Research Center in Fairway, which opened to patients on Jan. 23, in a building donated by the Hall Family Foundation in 2008. The gift will also support efforts by the cancer center, Children’s Mercy Hospital and the Stowers Institute to develop pediatric cancer drugs, a news release from the KU Cancer Center said. And it will contribute resources to a new drug discovery laboratory and the KU Medical Center’s newly established Department of Cancer Biology.

At Truman Medical Center, $3.5 million will help refurbish cancer facilities and fund Truman’s ongoing membership in the Midwest Cancer Alliance, a regional network of hospitals and health care organizations that is a component of KU Cancer Center’s bid for NCI designation.

The foundation’s latest gift brings to $29.9 million the total commitments made by the Hall Family Foundation in support of the effort to bring a NCI-designated cancer center to the region. The foundation’s involvement began in 2007, when it pledged $50 million to the Kansas City Life Science Institute with an initial emphasis on KU Cancer Center’s NCI initiative. Prior grants by the foundation have contributed $19.4 million toward that effort.

Officials said that the NCI designation unites Kansans and Missourians in the fight against cancer. Today, there are nearly 14 million cancer survivors in the United States, but there are disparities in how long cancer victims live. The Kansas City Health Department’s Community Health Assessment 2010 reports that among African-Americans, the likelihood of dying from cancer is more than 20 percent higher than for whites. And poor people with cancer tend to die earlier than those at the higher end of the economic scale.

“This insightful gift from the Hall Family Foundation not only assists in strengthening the collaborative regional partnership between Truman Medical Center and the KU Cancer Center but will be used for our ambulatory cancer care and to expand and renovate our chemotherapy facilities,” said Truman Medical Center President and chief executive officer, John W. Bluford. “Many of our cancer patients also suffer from serious social disparities and complex illnesses that compound their cancer diagnosis and treatment. Together with KU and the Hall Family Foundation we will strive to end this insidious disease for everyone once and for all.”

The KU Cancer Center submitted its application for NCI designation in September. NCI reviewers this week will be going over KU’s 600-page application and visiting the Cancer Center. University officials do not expect to learn whether the cancer center has been awarded NCI designation until at least May and possibly as late as September.

The cancer center is a partnership that includes cancer research and health care professionals associated with the KU Medical Center; KU Hospital; KU’s Lawrence campus; the KU School of Medicine-Wichita; the KU School of Medicine-Salina; the Stowers Institute for Medical Research; and the members of the Midwest Cancer Alliance.