A pilot program here that showed potential for significant health care cost savings is being cut off by the Kansas Health Policy Authority due to the agency’s budget problems; but local medical officials say they will attempt to keep the program going as long as they can with the money they have left.
“We have some unexpended funds and we are talking with our accountant, with our board of directors, and with the health policy authority about using these funds to keep the program going for as long as we can. I don’t know how far our reserves will go,” said Anne Nelson, associate executive director at Central Plains Regional Health Care Foundation, a nonprofit affiliate of the Medical Society of Sedgwick County.
The foundation oversees administration of the so-called Enhanced Care Management program, which has focused on providing intensive support to people with chronic illness.
Preliminary evidence from an evaluation done by Ruth Wetta-Hall, a researcher at the Wichita campus of the University of Kansas School of Medicine, showed that Medicaid utilization costs for 140 enrollees in the program were reduced 50 percent over two years from $11 million to $5.5 million.
According to the foundation overseeing the program, the $1.6 million the health policy authority put into the pilot, much of it federal matching funds, “leveraged a $5.5 million cost savings.”
But health policy authority officials said budget cuts ordered by the Legislature have left them no choice but to eliminate funding for the program and that they are still uncertain how effective the pilot was.
“The evaluation is in progress but incomplete at this time,” said Barb Langner, the agency’s policy director, “so we are not able to draw any conclusions about cost savings. Due to the budget cuts our agency unfortunately has had to terminate the ECM pilot project, which was assisting Medicaid beneficiaries in better managing their chronic illnesses.”
Langner said she was unsure when agency officials would complete their review of the program and its evaluation.
“The contract ends June 30, 2009 and it will not be renewed,” she wrote in an e-mail to KHI News Service. “Ruth Wetta-Hall is doing the evaluation and additional analytic work is needed and I am not sure the time-frame for getting that done.”
Wetta-Hall prepared the evaluation under contract to the health policy authority.
Nelson said the health policy authority’s critique of the program so had been “very positive, very complimentary.”
She said she was sympathetic to the budget situation faced by virtually all state agencies.
“This is really painful environment,” Nelson said. “I feel really badly for all the agency heads. This isn’t something that any of them want to do, but they’ve all been told they have to cut budgets. It’s a very difficult situation. It’s not their fault. We have a very good relationship with the health policy authority. We’re just hoping to extend the service to the vulnerable people who need it.”
Since March 1, 2006, the program has served 729 patients with 257 persons currently enrolled.
The program has medical teams that include nurses and social workers who work closely with the patients, assuring they have access to blood pressure monitors, weight scales, medication planners, shower chairs, and exercise tools. The program also connects patients and mental health and substance abuse services, credit counseling and legal aid.
The program has incorporated standards of care for several chronic diseases, including diabetes congestive heart failure and asthma.
Rep. Peggy Mast, R-Emporia, chair of the House social services budget committee, included in the House’s version of the Omnibus budget bill a provision that would have required the health policy authority to continue funding the program, despite the budget cuts.
Mast called the program a “common-sense way,” to reduce the state’s Medicaid costs.
But it was the Senate version of the Omnibus bill that ultimately passed the Legislature and unlike the House version it did not include a requirement the program be spared.
-Mike Shields and Dave Ranney are staff writers for KHI News Service, which specializes in coverage of health issues facing Kansans. They can be reached at 785-233-5443.