The Kansas Department of Social and Rehabilitation Services' managed care program for the Kansas Medicaid population begins in Sedgwick County July 1.

Preparation for this start-up has been in the works for more than two and one-half years and involved consumers, members of the Kansas medical community (including physicians, pharmacists and hospital administrators), state medical program staff, and consumer advocates.

With managed care, SRS, as directed by the Kansas Legislature, is completely revamping the method by which medical services are provided to vulnerable Kansans. Among goals of managed care are increasing access to medical care for the population served by Medicaid, improving the quality of medical services provided, and preventing unnecessary costs.

Managed care provides health care services using a single doctor or organization to emphasize preventive health care and a reduction in unnecessary care and cost. Medicaid consumers choose the doctor or organization they want to be their primary care provider. The primary care provider supplies all preventive and primary medical services and refers patients to specialists when needed.

The managed care program becoming operational in Sedgwick County July 1 is HealthConnect. This program is already operating well in Wyandotte, Johnson, Leavenworth, Saline, Ottawa, Ellis, Ness, Douglas, and Shawnee counties. By July, 1997, HealthConnect will be a statewide program.

Under HealthConnect, Medicaid consumers designate a primary care provider, which could be a doctor, a clinic, or an advanced registered nurse practitioner, to provide for their health care needs. The primary care provider is reimbursed on a fee-for-service basis in addition to a monthly case management fee. This type of managed care eventually will be available statewide, even in rural areas with no other managed care plan.

Enrollment in HealthConnect took place during May and June.

Because providers are willing to see more patients in the managed care program, access to medical care for Medicaid consumers is expected to increase. The numbers already show this trend.

Ann Koci, commissioner of Adult and Medical Services for SRS, said the new managed care programs will be a major improvement for beneficiaries and health care providers alike.

It's a consumer-driven system, where responsibility is placed in the hands of the consumer to choose their gatekeeper to the health care system," she said. Suddenly, the consumer is in the driver's seat. Beneficiaries will no longer have to battle to get their health care."

Most Medicaid beneficiaries, including those receiving benefits from the Aid to Families with Dependent Children (AFDC) and the Poverty Level Women and Children (PLE) programs, will enroll in HealthConnect. Medicaid beneficiaries in the Supplemental Security Income (SSI) program and the General Assistance (GA) program will also be in HealthConnect.

As the new managed care programs come on-line, there is bound to be an adjustment period, especially for consumers or providers who have not been able to attend informational meetings. consumers enrolled in HealthConnect can call 1-800-766-9012 for assistance.

Page Last Updated: May 29, 2001