Emphasizing home health care, personal responsibility for health, and early intervention in disease and drug abuse were among the many ideas floated at a public forum in Wichita on Thursday to reform the state's Medicaid system.
Nearly 400 people spent three hours in roundtable discussions at the Holiday Inn Wichita, 549 S. Rock Road, hashing out ways to lower costs and improve the system. "We're committed to a transformation process," Lt. Gov. Jeff Colyer, a surgeon, said. "Everything is on the table." Colyer is leading forums around the state as a prelude to tackling Medicaid's accelerating costs. The program provides health care for the poor, elderly and disabled and serves about 340,000 in Kansas. Spending on Medicaid in Kansas has increased an average of 7.5 percent annually over the past decade, and that is expected to grow as baby boomers age into the system. The state could face a $900 million deficit by 2016 without changes in the program, said Robert Moser, secretary of the Kansas Department of Health and Environment. Colyer said legislation will come out of the discussions, as well as administrative steps. He said the state will see major changes in the system over time, including an effort to look at ways to treat patients holistically. The problem's too big to fix all at once, but we're going to make big strides — emphasis on 'big' — this year," he said.
The first Medicaid meeting was in Topeka on June 22. Another will be held in Dodge City today, and plans are under way for one in the Kansas City area in August. "Our challenge is improve health care outcomes and control costs," Moser said. Rep. Jim Ward, D-Wichita, said during a break that he is skeptical that Gov. Sam Brownback can reduce costs and improve the quality of health care after already making cuts in home and community health care services, the Senior Care Act and mental health services. "He has said in meetings he plans to cut $200 million to $400 million" from the state's Medicaid system, Ward said. Wade Horn, of Deloitte Consulting, a former assistant secretary in the U.S. Department of Health and Human Services, said Medicaid, which is funded by state and federal governments, has grown from $1 billion in expenditures in 1966 to more than $400 billion in 2010. Other states are exploring ideas such as reducing the need to enroll people in the program by moving them into jobs where they can use employer-sponsored health care, reducing or eliminating benefits, reducing the unit cost of services, and improving the program's integrity, Horn said. Some states are cutting payments to Medicaid providers, like doctors and hospitals. Brownback said Wednesday that he is not ruling out cutting payments to health care providers, but that he is still waiting to see what comes out of Colyer's meetings.
'Long waiting lists'
Participants at the forum in Wichita included officials from state and local health care organizations, state lawmakers and members of the public.