“A pilot could help assess how direct primary care might work for various populations in KanCare,” Bruffett said in an email. “It could also be used to assess beneficiary interest, provider interest and capacity, and whether direct primary care could work either as an alternative to or an option within a managed care model.”The Kansas Department of Health and Environment, which manages Medicaid, told the Kansas News Service it hasn’t yet done a cost analysis of using direct primary care for Medicaid. But it’s open to a pilot program if it’s supported by a future governor and legislature.“Anything innovative like that, we would like to think it warrants exploration,” said Secretary Jeff Andersen.
Kris Kobach says his proposal to reform Kansas Medicaid could save the state $2 billion.
At campaign events, the Republican nominee for governor touts the benefits of combining Medicaid with direct primary care, an unconventional payment system that avoids the bureaucracy of health insurance.
But the people who gave Kobach the idea say they haven’t calculated that direct primary care would save $2 billion for Kansas Medicaid. And Kobach’s campaign hasn’t provided an alternative source for that number.
On top of that, health experts say the idea oversimplifies one of the state’s largest and most complex expenditures. While direct primary care is a familiar idea in Kansas in private practice, no one knows whether it could work with Medicaid’s complex structure and recipients’ specialized needs.
Direct primary care clinics offer patients discounts on procedures, medications and lab tests. They typically don’t take insurance, which saves doctors the hassle and overhead costs of dealing with insurance companies. The Kansas Department of Health and Environment says about 30 doctors use the system in Kansas.
For years, lawmakers have considered bringing direct primary care to KanCare, the Medicaid program that serves 425,000 of the state’s most vulnerable residents. Now, Kobach and his independent opponent, Greg Orman, have included the proposal in their campaign platforms.
“If we had successful direct primary care for our KanCare system, the $3.2 billion that we’re spending for 400,000 people would go down to $1.3 billion for the same 400,000 people,” Kobach said at a July candidate forum in Garden City. “There is an opportunity to realize great savings in our KanCare system.”
Kobach’s other statements on the subject are frequent, but lack detail. His campaign website doesn’t include a section on his proposals for health policy. At an October press conference, Kobach told the Kansas News Service he would introduce a direct primary care pilot program to one county or region before expanding it to Medicaid across the state and, he promised, reaping $1.9 billion dollars in savings.
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