If you farm out Medicaid care for the elderly to three low bid contracts on a flat fee per enrollee basis what could possibly go wrong? (see here)

Sarcasm aside, enacting KanCare will take more of those Medicaid Waivers that the GOP campaigned on and used to attack President Obama with. The program as envisioned has high hopes, but the over-reliance on the hard right philosophy that Private Enterprise can fix anything by Brownback’s administration has me wondering how many KanCare horror stories I’ll be reading about in the papers in coming years. It has me wondering if I will need to sell the house and move across the state line before I retire as well.

Some are already affected by this change, and worried about what the future of Kancare will be like:

What this means in southwest Kansas is that all of the Medicaid customers formerly served by area agencies on aging will now have case managers through an insurance company, also known as a managed care organization or MCO. Also, the place where I work now has a new name. Effective November 1, 2013, the Southwest Kansas Area Agency on Aging has morphed into the Southwest Kansas Aging and Disability Resource Center (SWKADRC), Due to losing essentially half of our customers, the main office for SWKADRC in Dodge City has initiated layoffs at the main and satellite offices, including Pratt, to compensate for projected revenue losses beginning next year. Subsequently, I will soon lose two great co-workers, one of whom begins employment with an MCO on November 26. I hope to remain employed with my new/old employee for many years to come, but I can’t help but think of the saying, ‘Will the last person to leave please turn out the lights?’

This is especially worrisome as my wife and I both approach retirement next decade and the record of this administration when administering Medicaid is just not so good.

With the flat fee structure the three low bidders have every reason to increase margins by cutting costs, and we know where that can lead in health care. What checks, what balances, what enforcement is in place? Can we trust the Brownback administration to do this right or should we expect them to put national grandstanding above the needs of Kansans based on prior history?

On the other hand the three bid winners are respectable companies, doing pretty well at administering private Group and HMO contracts for private enterprise, and one is my health care provider & they do great for me now. (That’s a disclaimer coupled with an endorsement for UHC folks.)

So I will be watching how this goes very closely the next few years as this is something near and dear to my heart after my Quintuple bypass a couple years back.