KS hospitals say they're getting squeezed by Medicaid plans

Since the state of Kansas moved its Medicaid population into managed care earlier this year, hospitals in the Sunflower State have collided with the tight-fistedness of commercial insurers, the Wichita Eagle reported.

The conflict between payers and providers on the Medicaid issue could multiply, as other states have recently pushed to move their program enrollees into managed care. These states include a few who wish to do so as a condition for expanding their Medicaid programs.

Several hospitals in the Wichita area--including large operators such as Via Christi Health--have seen a surge in rejected claims for the Medicaid patients it treats, according to the Eagle.

"It's clearly created significant financial pressures on us in 2013, and we're questioning what our financial position will look like later in 2013 and 2014," Hugh Tappan, chief executive officer of Wesley Medical Center in Wichita, told the Eagle. 

Medicaid payers are denying up to $400,000 a month, and $1.6 million so far this year, according to Matt Leary, Wesley's chief financial officer. Medicaid payers denied claims involving 550 patients in calendar 2013, compared to 263 during the same time period in 2012.

Altogether, about 320,000 Kansans are enrolled in KanCare, the state's Medicaid program. Three commercial insurers run the program. 

In Florida, the state recently received federal approval to move its Medicaid enrollees into managed care, although it appears unlikely that it will expand its program as part of the Affordable Care Act. Kentucky, which plans to expand its Medicaid program, moved most of its enrollees into managed care last year.

To learn more:
- read the Wichita Eagle article

Related Articles:
Florida gets approval for private Medicaid expansion
Blue Cross bows out of state Medicaid privatization
Kentucky pushes massive statewide Medicaid managed-care plan
Texas inches toward Medicaid managed care

 

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