Having a choice of providers has consistently been important to Americans when it comes to health care. Concerning something as consequential as personal health, people want to go to the doctor's office, clinic, or Health Maintenance Organization (HMO) of their choice.

On February 1, 1997, two new managed care programs for persons who receive medical assistance under Medicaid through the Kansas Department of Social and Rehabilitation Services (SRS) will begin operating in Brown, Doniphan, Jackson and Jefferson counties, HealthConnect and PrimeCare Kansas.

Enrollment packets for HealthConnect and PrimeCare Kansas will be mailed to beneficiaries in these counties during December. Information meetings to explain the programs to both beneficiaries and providers of medical care will also be scheduled during December and ??January.

Beneficiaries may enroll in one of the managed care programs during

these informational meetings. Enrollment can also be done by mailing the enrollment card provided in the packet or by calling toll-free 1-800-766-9012.

With both managed care programs, Medicaid beneficiaries are being asked to choose a primary care provider. The primary care provider, who could be a physician, an advanced registered nurse practitioner, a clinic, or a primary care provider within a Health Maintenance Organization, will supply all preventive and primary medical services. The primary care provider will refer them to specialists when needed.

Persons receiving public assistance who do not select a primary care case manager or managed care health plan will be assigned to one.

SRS Secretary Rochelle Chronister said the goals of managed care is to improve the quality of medical service being provided beneficiaries, increase their access to health care, and contain cost increases.

A key factor in meeting these goals is that beneficiaries choose a primary care case manager they are comfortable with to provide for their health care needs," she said. A major intent of managed care is to build relationships between consumers of medical care and their health care provider in order to build continuity of care and prevention."

Most Medicaid beneficiaries will have a choice between enrolling in the HealthConnect or PrimeCare Kansas managed care plans, including beneficiaries in the Aid to Families with Dependent Children (AFDC) and the Poverty Level Women and Children (PLE) programs. Beneficiaries in the Supplemental Security Income (SSI) program and the General Assistance (GA) program need to enroll in HealthConnect.

Under HealthConnect, which is a primary care case management

(PCCM) program, beneficiaries will designate a primary care provider and go to him or her for all their health care services. The primary care provider will refer the beneficiary to specialists when needed.

Under PrimeCare Kansas, beneficiaries will choose one of three

HMOs operating in Wyandotte County under contract with the state, Humana, HealthNet, and Blue-Advantage+ Plus. Beneficiaries who choose to

join one of the HMOs also choose the primary care provider within that HMO who they would like to see for their health care needs. Similar to HealthConnect, the primary care provider will refer the beneficiary to specialists when needed.

Beneficiaries in either managed care program in Wyandotte County will receive a blue identification card. Beneficiaries not in managed care programs will continue to receive green identification card previously used by all Medicaid beneficiaries.

Page Last Updated: May 29, 2001