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High Plains Mental Health adjusts to Medicaid changes

By KALEY CONNER

kconner@dailynews.net

A week into the new year, health care providers and patients throughout the state are adapting to significant changes in Kansas' Medicaid program.

Medicaid services now are administered by three private, managed care companies: Amerigroup of Kansas, Sunflower State Health Plan and United Healthcare of the Midwest. State officials said the changes will save taxpayer dollars.

"Serving the needs of the whole person as well as ensuring long-term fiscal sustainability for the state are the principles this plan is built upon," Lt. Gov. Jeff Colyer said in a press release.

The changes were effective Jan. 1.

Walt Hill, executive director of High Plains Mental Health Center, was appointed in March to a state advisory council helping to implement the new system, known as KanCare.

The idea is to better coordinate aspects of medical care and reduce costs by creating "health homes" for the state's approximately 380,000 Medicaid enrollees. Rather than separate Medicaid entities for physical health and mental health, the three new companies will cover comprehensive care.

It's hoped this model will result in financial efficiencies. The amount of care covered by Medicaid will not be reduced, Hill said.

"The state has made sure companies aren't reducing the amount of service authorizations, or how frequently the cases have to be reviewed," Hill said. "Really the idea is for people with long-term mental health disabilities ... if we can help them deal with mental health and substance abuse issues, they're going to have fewer physical health costs."

Certain physical ailments have been tied to mental disorders. For example, those with depression have a higher instance of coronary artery disease, he said.

More preventive resources, which are intended to reduce health care costs, will be available for state Medicaid patients.

At High Plains, Hill said the outlook mostly is positive. The facility is contemplating the addition of physical health services to create a one-stop shop for consumers.

Staff is communicating with the facility's approximately 1,500 Medicaid patients about the changes and helping them choose the policy that's right for them. Patients were auto-assigned to one of the three plans, but were given 90 days to choose another company.

The three companies offer similar basic health services, but each offers various value-added benefits, such as career development help and financial assistance for over-the-counter drugs.

There have been a few glitches. Some patients were not assigned to the primary care physician they have been seeing, Hill said. In those cases, patients are directed to a state Medicaid ombudsman to resolve the issue.

"Time will tell," Hill said of implementing the changes. "But my sense is when there are glitches, we'll be able to work things out."

High Plains is contracted with all three companies. Besides possibly needing to change plans and having more contact with a managed care company, Medicaid patients should not notice significant changes, Hill said. The facility's in-house pharmacy also will be covered by all policies.

Though only about a quarter of High Plains' patients are Medicaid enrollees, the program makes up nearly 75 percent of the facility's patient revenue.

The statutory role of community mental health centers has not changed. As a CMHC, High Plains will continue to serve as a gatekeeper for state hospital admissions and the local mental health authority appointed by area counties.

"We aren't going to let people get caught falling between the cracks," he said. "Our philosophy has always been take care of the patient first, then deal with the payment issue."