Blue Cross bows out of state Medicaid privatization

Blue Cross Blue Shield of Kansas has decided not to participate in the state's shift toward privatizing its Medicaid program. 

The decision announced Wednesday means the state's largest health insurer won't be submitting a proposal to become a private Medicaid contractor, reported the Kansas City Star.

Under Kansas Gov. Sam Brownback's (R-Kan.) plan, all Medicaid members would shift into a private managed care program. But Blue Cross spokeswoman Mary Beth Chambers said the Medicaid contracts would require the insurer to provide services that it doesn't currently offer, such as helping families decide whether they should admit elderly members into a nursing home, according to the Associated Press. "We just felt it wasn't responsible for us to commit to changing our business model that much," Chambers said.

"In the end, although we believe the [request for proposals] may present a sizeable opportunity, it would have required us to dramatically change our business model to serve new populations in different settings in less than a year," Angie Strecker, director of institutional relations for Blue Cross, wrote in a letter to providers. "We decided that we could not responsibly commit to so great a change at this time."

Chambers clarified though that the Blue Cross decision shouldn't be interpreted as a criticism of Brownback's plan to privatize Medicaid, the AP noted. "We certainly have no intent - and would be disappointed - if people read our decision as criticizing the governor's proposals," she said.

Meanwhile, state Rep. Jim Ward (D-Kan.) introduced a bill (H.B. 2573) that, if implemented, the privatization plans would require Medicaid contractors to undergo annual audits to ensure Medicaid recipients' benefits aren't reduced, the Kansas City Star noted.

The audits would determine whether changes were made to the quality or quantity of service, the number of people receiving services or rates paid to providers. They also would survey Medicaid contractors and recipients to find out whether they're satisfied with the new program, the Wichita Eagle reported.

To learn more:
- read the Kansas City Star article
- see the Wichita Eagle article
- check out the Associated Press article