During a recent meeting of the Peer Education and Resource Council (PERC), Lou Greenhaw, a pharmacist who operates Greenhaw Pharmacy in Hillsboro, described to other council members how she relates to customers whose prescriptions are paid through use of a Medicaid medical card.

I tell them that is your health insurance; it's just another health insurance card," she said.

Greenhaw's assessment of Medicaid as another health insurance program is becoming more and more accurate as Kansas moves forward with a statewide system of Medicaid managed care. By July, 1997, 80 percent of the state's 200,000 Medicaid recipients will be part of a managed care system. Under managed care, patients see a single provider or organization for their health care services. The program emphasizes preventive health care and a reduction in unnecessary care and cost.

PERC is a group of 11 physicians, pharmacists, osteopaths, and nurses from across Kansas who have agreed to help with the transition to managed care. Their charge is to help provide education and quality control for the providers and consumers of medical care in HealthConnect, one of three managed care programs now coming on line across Kansas.

Dr. Wayne Wallace, PERC chairperson who operates a medical practice in Atchison, sees a dual role for the committee.

The committee has to be on top of the latest developments in health care; that's the reason to have the entire health care spectrum represented. We are all interrelated," Dr. Wallace said.

Hopefully, we can develop guidelines that physicians and others can follow to give good care," he said. And we will be recommending disciplinary action for physicians not providing good care. And, by the same token, we will provide similar education, support, and maybe even disciplinary action for recipients who abuse the program."

HealthConnect is a primary care case management program. Like private insurance company's managed care programs, HealthConnect providers will treat patients for their primary health care needs. The primary care providers, whether a doctor, clinic, or advanced registered nurse practitioner, will refer patients to a specialist when needed. HealthConnect has already begun in four central Kansas counties and in Wyandotte County, and will be in place statewide by July, 1997.

As in all of managed care, whether public or private, quality of care and provider/patient education is a major key to success. By emphasizing preventive health care services, SRS and managed care providers hope to avoid unnecessary care and unnecessary costs.

According to SRS Secretary Rochelle Chronister, PERC members will also provide valuable input to the agency as it implements managed care.

We need them; we need to know what it's like to provide medical services out there," Chronister said. What are the daily obstacles they are facing in trying to implement our programs? And how do we make it easier?"

Ann Koci, SRS commissioner of Adult and Medical Services, said Kansas taxpayers have a tremendous financial stake in good health care outcomes. She pointed out the Medicaid program is supported by our taxes, both federal and state.

Koci said HealthConnect is, in effect, the state's own health insurance company Kansans eligible for Medicaid.

We need to have a way of managing medical care and making sure proper treatments and procedures are being proscribed and delivered," she said. The PERC committee will help educate their peers on better ways of delivering care."

PERC is expected to help primary care providers keep on top of the latest developments in health care, provide consultation and recommend

initiatives which enhance the quality of health care and access to services while controlling Medicaid costs.

Other duties of PERC include:

*Participate in researching and analyzing studies regarding health care issues;

*Analyze trends and patterns of care;

*Participate in identifying appropriate standards of care;

*Assist in the evaluation of peer group profiles and make appropriate recommendations; and

*Participate in the creation and resolution of provider corrective action plans.

Members of Peer Education and Resource Council include:

Wayne Wallace, M.D., Atchison, chairperson, Sallie Page-Goertz, ARNP, Kansas City, Mary Tawadros, M.D., Topeka, Robert Frayser, D.O., Hoisington, Yvonne Gibbons R.N., BSN, Salina, Lou Greenhaw, R.Ph., Hillsboro, James Mirabile, M.D., Overland Park, Richard Price, D.O., Wichita, Charles Quinn, M.D., Kansas City, Marty L. Schmidt, M.D., Fort Scott, and Michael Sherman, M.D., Kansas City.

Page Last Updated: May 29, 2001