Aetna Takes Amerigroup Spot in Kansas Managed Medicaid Contract

Aetna has received a Managed Medicaid contract from the state of Kansas for plan year 2019 and will replace Amerigroup as one of the state’s three managed care payers.

The state received six bids from commercial payers and determined that bringing Aetna in as a managed care organization (MCO) would better benefit the goals of KanCare, the state’s Medicaid program.

Medicaid officials decided to keep Centene’s Sunflower State Health Plan and UnitedHealthcare’s Community Plan as MCOs, and switch out Amerigroup for Aetna.

 

The state believes that the new set of payer participants will provide greater oversight, improved response to consumer needs, enhanced care coordination, employment and behavioral health supports, and new value-added benefits for Medicaid beneficiaries

“These new KanCare contracts will provide Medicaid waiver consumers with enhanced, comprehensive care and services,” said Kansas Department for Aging and Disability Services Secretary Tim Keck. “We are looking forward to offering them improved care coordination and more work opportunities that will encourage them to grow and thrive while living in their home communities.”

The contract allows Aetna to provide KanCare members with medical benefits as well as long-term support services and behavioral health benefits. Currently, Aetna serves nearly 2.8 million managed Medicaid beneficiaries across 15 states.

Janet Grant, Vice President of Aetna Better Health’s Great Plains Region, expressed eagerness to work with the state of Kansas to provide benefits to Kansas’s most vulnerable beneficiaries.

“We appreciate the State’s fair and thorough evaluation process and we’re confident we can deliver improved health status, better access to coordinated care and greater emphasis on prevention and education,” Grant said in a press release.

“We are known nationally for our ability to establish collaborative relationships with health care providers and community leaders that focus on making members healthier and improving their health care experience.”

However, Amerigroup will appeal their exit from KanCare managed program, and use a formal bidding process to contest the state’s decision, the Kansas City Star reported.

Denise Malecki, a spokesperson for Amerigroup, told the Star that her organization is disappointed the decision after Amerigroup has helped initiate the state’s managed care program back in 2013.

“We are committed to working collaboratively with the state to review the process and determine the best approach for moving forward,” Malecki said. “In the meantime, we remain focused on our top priority — the Kansans we serve. As we proceed with our protest, we will work diligently to ensure individuals have uninterrupted access to services, and deliver care that helps improve their health and well-being.”

Pending the appeal, Amerigroup’s managed care beneficiaries will be able to enroll in a new MCO starting in October and can use their benefits until December 31, 2018.

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