State abruptly delays Medicaid health home service

Medicaid

TOPEKA, Kan. (AP) — A new Medicaid service that would provide intensive case management for Kansas residents with chronic medical conditions was postponed just one day before it was scheduled to start this week because the state could not find enough care providers.

The service, known as a “health home,” has been delayed until at least January for people with chronic medical conditions, the Kansas Department of Health and Environment said in an email it sent Monday afternoon, a day before the service was set to begin.

A health home service for people with severe mental illness will move forward, however, KDHE spokeswoman Sara Belfry said.

The Affordable Care Act gives states the option of offering the health home service through their Medicaid programs, the Lawrence Journal-World reported. The idea is that Medicaid programs could contract with providers such as Heartland Community Health Center in Lawrence, which would help coordinate all the medical care for those patients and help them learn how to make wise health care decisions for themselves.

Under the ACA, the federal government would pay 90 percent of the cost of the health home services for the first two years, rather than the 57 percent it pays for most other Medicaid services.

But health homes for people with chronic conditions such as diabetes, asthma or heart disease are being delayed because KDHE — which manages Medicaid in Kansas — couldn’t find enough contractors to cover the whole state.

Under federal rules, Belfry said, the state must be able to offer patients a choice of at least two providers before the state can take part in the program.

“We did not have the network adequacy,” she said.

The abrupt delay has left agencies like Heartland, which already had hired additional workers to help implement the program, in a lurch.

“We’re going to have to scramble,” said Jon Stewart, CEO of Heartland, which had intended to provide the service to chronically ill Douglas County residents. “We put a ton of time and energy into making this happen. … But this delay, it was incredibly disruptive.”

Stewart said the goal is to improve the quality of care they received and lower the cost by reducing otherwise avoidable costs. Heartland already had identified 300 to 500 patients in Douglas County who would qualify for the service, he said, and he expected the number to grow after the program was launched.

He said Heartland had already hired two new staff members to work in the health home program and was in the process of recruiting two more.

“This leaves us in serious limbo,” he said. “The energies we’ve spent recruiting — what do we do there? How do we engage these people? What damage has been done in that recruiting relationship?”

 

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