New alliance emphasizes social determinants of health in bid for Kansas Medicaid contract

TOPEKA — Four organizations have joined in a bid for a slice of the state’s $3.9 billion KanCare contracts.

InterHab, the Children’s Alliance, the Association of Community Mental Health Centers of Kansas and CareSource Kansas announced their alliance Wednesday, collaborating under the name of CareSource HealthAlliance.

KanCare is the state-run system for the federal Medicaid program, which provides health care services to low-income families. The alliance goal is to create a KanCare system focused on addressing social determinants of health.

Matt Fletcher, executive director of InterHab, an organization serving Kansans with intellectual and developmental disabilities, said the contract renegotiation would give the state a chance to fix problems with the KanCare system, bringing operations into line with other states.

“These are the longstanding issues that have plagued the KanCare system since its inception: accountability, oversight and transparency,” Fletcher said. “Particularly the ability to share data that is being collected within the KanCare system has been a challenge since its inception and continues to be a challenge for the state.”

The bidding process will determine which organizations will manage the state’s Medicaid system. Former Republican Gov. Sam Brownback privatized Medicaid in 2013 and handed out no-bid contracts through executive order. 

The contracts were set for renegotiation in 2022, following the 2018 reprocurement process, but the GOP-controlled Legislature pushed through a one-year, no-bid contract extension to give Republican Derek Schmidt a chance to install new deals if elected governor. Democratic Gov. Laura Kelly won reelection instead.

The three KanCare insurance companies that currently operate Medicaid health services are Sunflower State Health Plan, United Healthcare and Aetna Better Health of Kansas. They serve thousands of Kansans, including elderly adults, low-income children and people with developmental, intellectual or physical disabilities.

Children’s Alliance of Kansas CEO Rachel Marsh said prioritizing the needs of parents and children within the welfare system would be an important step forward for the state.

“If we get that right, we will by necessity be getting all the other things right,” Marsh said. “That’s where I’m hopeful about this, is that the CareSource alliance will help us better address the needs of the most complex children.”

Fletcher said he thought the IDD system management was flawed under Brownback, but he was optimistic Kelly’s administration could smooth some of the cracks in the system.

“I don’t think there was very good execution in the (Brownback) administration in carrying that out,” Fletcher said. “What I see that is different in the Kelly administration is that whether it be at the administrative level, or within the agencies, there is a desire and ability to operationalize the elements that need to be done to improve the lives of Kansans with intellectual and developmental disabilities.”

The bid renewal process comes at a crucial time for the state, with the April unwinding of pandemic-era health care protections. An estimated 120,000 Kansans allowed to remain in Medicaid during a three-year pandemic suspension are now at risk of losing coverage if they fail to reapply for renewal.

The Kansas Department of Health and Environment also has begun a review process to determine Medicaid eligibility for one-fourth of the 530,000 Kansans enrolled in the program during the height of the COVID-19 pandemic.

The move also comes after another legislative session in which Republican leaders refused to consider a vote on Medicaid expansion, which would unlock an estimated billion dollars in annual federal aid while extending coverage to an additional 150,000 low-income Kansas adults and children.

Kansas remains one of 10 states that hasn’t yet adopted Medicaid expansion.

Correction: A previous version of this story gave an incorrect timeline for the contract procurement process.