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HaysMed finalizes KanCare contracts


With the state deadline just a few weeks away, Hays Medical Center has finalized contracts with all three private insurance companies hired by the state to administer the Kansas Medicaid program, known as KanCare.

The hospital first announced a contract with Sunflower State Health Plan in January and recently finished negotiations with the other two companies, Amerigroup of Kansas and United Healthcare of the Midwest.

"I think it was important for the patients that we serve to contract with all three," said Chief Financial Officer Bill Overbey.

HaysMed administrators previously said there were sticking points in negotiations with the other two companies. Overbey said he is confident the hospital's concerns have been addressed.

The state's approximately 380,000 Medicaid enrollees randomly were assigned to one of the three managed care organizations and given until April 4 to switch insurance providers. After the upcoming April 4 deadline, Medicaid patients will be locked in to their current policy for a year.

While all three companies offer similar plans for basic coverage, each touts different "value-added services," or additional health benefits. Those benefits have influenced some patients to choose a certain policy, Overbey said.

"Certainly, there probably has been a group of patients that have been concerned if we would contract with their MCO or not," he said. "Generally, what we heard was that people who had been assigned to an MCO were wanting to stay with that MCO because they believed that the value-added services given ... were better than what they could get from the other (companies)."

Had a contract not been reached with all companies, reimbursement rates would not have changed until April 1. After that time, reimbursement would have dropped to 90 percent for patients covered by a Medicaid policy not accepted by the hospital.

Now that contracts are finished, Overbey said efforts to fully transition into the new KanCare system are just beginning. An advisory group with the Kansas Hospital Association, of which Overbey is a member, is asking the three companies to standardize company policies regarding issues such as data requirements for claim submission and appeals, he said.

Staff also will have to adjust to the process of working with three Medicaid companies instead of one.

"And now the work, the complicated work, still doesn't end at this point," Overbey said. "Claims processing and appeals processing are very complicated, and it will take constant monitoring to ensure proper payment."

HaysMed is northwest Kansas' largest hospital and a regional referral center. Medicaid payments account for approximately 5 percent of the hospital's gross revenue.