The Kansas Health Institute has nailed it.

KanCare – to paraphrase – is likely to be a mess when it is implemented on Jan. 1.

On that date 380,000 poor and disabled Kansans, who now receive services through Medicaid, will be shifted to private, managed care in an attempt to save money. The new program is called KanCare.

The KHI researched what has happened in Kentucky, which recently has implemented what we are about to implement. And, so far, it has had lots of hiccups.

And Kentucky did not even include three categories that are included in the Kansas plan: long-term services for the elderly, physically disabled and, eventually, the developmentally disabled.

Personally, I am not opposed to the overall concept. Clearly, Medicaid costs are out of control, and the best hope for efficiencies is through some sort of fixed-rate managed care, although — as I have written before — the developmentally disabled should never go to managed care.

But this must be done very, very carefully. And the way it looks, Kansas will not be prepared by Jan.1 to make a smooth transition.

According to KHI news service, the state auditor from Kentucky said that Kentucky spent less than six months assembling its reform package. In hindsight, he said, it should have spent a year to 18 months.

Kansas is in the same rushed time frame as Kentucky. Here it is in the summer, and Kansas just picked its three managed care organizations.

Also, according to Anna Lambertson, executive director of the Kansas Health Consumer Coalition, “We don’t have a clear picture of what the legislative oversight is going to look like, or if there’s even going to be any.”

Of course, there should be legislative oversight. To leave this to officials working for Gov. Sam Brownback is asking for trouble. Who will represent the 380,000 citizens on KanCare, if not their legislators?

So much can go wrong.

Just ask the auditor in Kentucky.

He told KHI news service, right after the managed care plan went into effect, he started getting phone calls from patients who were “frustrated, because they couldn’t get in to see the doctors they were used to seeing.”

Then, he said, “I started hearing from providers who’d gone 90 days without being paid.”

Those are but two examples of the problems Kentucky has run into since reforming their system.

Who knows what problems Kansas will run into, if the plan is implemented without enough time and without oversight?

Brownback’s administration should postpone implementation for at least a year and do it right.

And the Legislature should flex its muscle and make certain that there is oversight for programs as vital as the ones to be delivered under KanCare.

All you have to do is look at the unmitigated disaster at DMV to see what happens when a new system is launched without proper preparation.

| Special to The Star