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KDHE: KanCare 3 rollout stable so far; community care coordination delayed until 2026
Summary
KDHE officials reported early implementation of KanCare 3 and the January 1 transition of Healthy Blue, citing stable claims and call‑center performance while noting a planned community care coordination program has not yet been implemented and is projected for January 1, 2026.
Christine Osterlund, deputy secretary for agency integration and state Medicaid director at KDHE, briefed the committee on KanCare 3 implementation and early performance of new managed‑care coverage rolled out Jan. 1.
Osterlund said KanCare 3’s primary non‑rate new element—community care coordination—was not implemented at contract start and that full implementation is projected for Jan. 1, 2026. Most other contractual changes were non‑rate‑impacting clarifications intended to strengthen accountability (network adequacy monitoring, non‑emergency medical transport standards and care coordination ratios).
On the transition, KDHE reported Healthy Blue went live Jan. 1, processed pharmacy claims at the first minutes of the new year, and met network adequacy standards prior to go‑live. KDHE set up daily or frequent implementation meetings with Healthy Blue and Aetna (the departing MCO) and said Healthy Blue processed medical claims in controlled batches to monitor accuracy; KDHE reported that, as of Feb. 13, Healthy Blue had processed about 82,127 medical claims ($27 million in paid claims) and 133,186 pharmacy claims ($11.7 million), with paid/denied/rejected rates within expected ranges. Healthy Blue’s member and provider call‑centre abandonment rates remained low (below 1 percent) during early operations.
Osterlund also summarized the actuarial rate‑setting process: annual rate increases for 2025 reflect actuarial work (medical inflation, utilization and acuity) and would have occurred whether KanCare 2 continued or KanCare 3 began; the only budget‑impact driver in KanCare 3 noted as new is the community care coordination program, with an MCO‑estimated implementation range of $20–$25 million that has not yet been activated.
KDHE said it continues weekly meetings with Aetna to monitor claims payment during the transition and that Aetna has cooperated in paying legacy claims while transitioning out of the state.
