October 2, 2001 - Health insurance programs merge to provide children and families with better continuity of care; blended program to be known as HealthWave

Two programs providing health insurance for thousands of Kansas children and families with limited incomes - Title XIX Medicaid and Title XXI HealthWave - have been blended together to promote continuity of care. Both programs are funded through a state/federal partnership.

Under the change, the managed care portion of both programs will be known as HealthWave, and FirstGuard Health Plan Kansas Inc. will provide the medical services through its service network. In addition to blending the two programs, a simplified application was also created to make it easier for families to apply for services.

In 1997, the United States Congress offered states the opportunity to design a health insurance program for children that mirrored private health insurance programs. The Kansas Legislature and the Department of Social and Rehabilitation Services (SRS) took on the challenge and created HealthWave, which provides health insurance to children and adolescents up to age 19 who do not have health insurance and whose families have incomes at or below 200 percent of the federal poverty level.

The successful HealthWave program is now being blended with the managed care portion of Medicaid for low income children and families. Currently, HealthWave provides health insurance for 23,042 children and Medicaid for low income families in managed care provides health insurance for 41,276 children and 7,376 adults. The combined HealthWave program will be serving more than 64,000 children and over 7,000 adults.

Other parts of the Medicaid program such as coverage for people with disabilities or the elderly will be unchanged by the integration. HealthConnect, the Primary Care Case Manager program in Medicaid will also be unaffected by the change.

For consumers, the merger of the two managed care systems means that two children in the same family will no longer need to see different health care providers simply because they receive services from different managed care programs. It also means that when a family’s income changes, they will no longer have to move to a different health care insurance program as a result of the change in income.

"The blended program promotes better care management, better preventive medicine," said Janet Schalansky, SRS Secretary.

A major reason for blending the two health insurance programs is due to the fact that children and families often move in and out of each program depending on their family income. For instance, almost three quarters of children insured by HealthWave had previously been insured by Medicaid. And more than a third of children and families that lose coverage under HealthWave reverted to Medicaid for their health insurance needs. In addition, a quarter of children covered by HealthWave also had family members covered by Medicaid.

Under the new HealthWave program, the children and families will not have to change providers or managed care organizations when these changes occur. When a family’s eligibility changes, as it does quite often as the statistics above indicate, the family will be called and told they can move to another program but may keep the same health care provider and managed care organization.

"This will be much more customer friendly," said Secretary Schalansky."Separate managed care systems created confusion and hassle for families. The change creates a more seamless system for consumers."